Segmentectomy or Lobectomy in T1N0M0 non-small cell lung carcinomas: the prognostic role of histology and vascular invasion

Abstract

Lobectomy 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. Methods We 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. Results After matching, baseline characteristics were well-balanced. The segmentectomy group had a significantly higher rate of VATS procedures and adenocarcinoma histology (both p