ArticleUpdates in surgery2026
Segmentectomy or Lobectomy in T1N0M0 Non-Small Cell Lung Carcinomas: The Prognostic Role of Histology and Vascular Invasion.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionLobectomy is the standard surgical approach for early-stage non-small cell lung cancer (NSCLC), while segmentectomy has gained increasing attention as a parenchyma-sparing alternative. Recent randomized prospective trials have demonstrated comparable survival outcomes between the two procedures in patients with peripherally located, node-negative NSCLC ≤ 2 cm. This study aimed to compare survival outcomes between segmentectomy and lobectomy in patients with T1N0 NSCLC.
methodsWe conducted a retrospective, multicenter study using data from six thoracic surgery clinics across Türkiye. Initially, 317 patients who underwent segmentectomy and 252 who underwent lobectomy were identified. After 1:1 propensity score matching with a 20% tolerance for demographic differences, 223 patients from each group were included. The groups were compared in terms of clinical, pathological, and survival characteristics.
resultsAfter matching, baseline characteristics were well-balanced. The segmentectomy group had a significantly higher rate of VATS procedures and adenocarcinoma histology (both p < 0.001). In contrast, the lobectomy group had larger tumors and higher rates of pleural, perineural, lymphatic, and vascular invasion, as well as STAS (p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p = 0.02 respectively). Segmentectomy was associated with a shorter hospital stay and fewer pulmonary complications (p < 0.001 and p = 0.002, respectively). Although median survival was longer in the segmentectomy group, the difference was not statistically significant (p = 0.062). Non-adenocarcinoma histology and vascular invasion were identified as independent predictors of poor prognosis (p < 0.001 and p = 0.017, respectively).
conclusionsSegmentectomy offers comparable survival to lobectomy in T1N0 NSCLC while providing perioperative advantages. Histological subtype and vascular invasion remain important prognostic factors, necessitating close monitoring in high-risk patients.
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