Indications for segmentectomy in early-stage lung cancer based on solid volume analysis using three-dimensional computed tomography.

objectivesAs indications for segmentectomy in small lung cancers expand, accurate preoperative computed tomography (CT) evaluation has become increasingly important. Irregularly shaped tumors require objective measurement techniques. This study assessed new segmentectomy criteria for early-stage non-small-cell lung cancer (NSCLC) using three-dimensional (3D) CT tumor volume.

methodsIn total, 200 segmentectomies and 691 lobectomies for clinical stage 0/IA NSCLC were retrospectively analyzed. Preoperative 3D-CT was performed to measure total tumor volume and solid component volume. To assess the predictive value of solid component volume and solid component ratio for recurrence and mortality, the receiver operating characteristic (ROC) curves for the segmentectomy and lobectomy groups were plotted individually. Based on the cut-off values derived from the ROC curves in the segmentectomy group, all cases were stratified into four categories ("volume high risk + ratio high risk", "volume high risk + ratio low risk", "volume low risk + ratio high risk", "volume low risk + ratio low risk"). Recurrence-free survival was analyzed using the log-rank test.

resultsThe cutoff values were 2063.4 mm

conclusionsThis exploratory analysis suggests that 3D-CT tumor quantification may aid in refining segmentectomy criteria; however, external validation is necessary before clinical application.