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Subsegment-Based vs Segment-Based Anatomical Sublobar Resection for Lung Cancer: A Propensity Score-Matched Analysis.
Wenzheng Xu1, Zhihua Li1, Jianan Zheng1
1Department of Thoracic Surgery, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
The Annals of Thoracic Surgery
|February 19, 2026
Summary
Sublobar resection based on subsegments (SLR-Subseg) offers comparable surgical margins to segment-based resection (SLR-Seg) for early-stage lung cancer. This approach preserves more lung tissue by resecting fewer subsegments.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Lung cancer treatment often involves sublobar resection.
- Standard sublobar resection based on segments (SLR-Seg) may resect excessive lung tissue.
- Sublobar resection based on smaller anatomical units like subsegments (SLR-Subseg) is hypothesized to preserve more parenchyma.
Purpose of the Study:
- To compare the efficacy of sublobar resection based on subsegments (SLR-Subseg) versus segments (SLR-Seg) in early-stage lung cancer.
- To evaluate surgical margin status and parenchyma preservation between SLR-Subseg and SLR-Seg.
Main Methods:
- Retrospective screening of patients with clinical T1N0M0 lung cancer undergoing SLR-Subseg or SLR-Seg from June 2014 to December 2020.
- Propensity score matching (1:1 ratio) was utilized to minimize confounding factors.
- Analysis included comparison of inadequate margin rates, number of resected subsegments, and long-term survival outcomes.
Main Results:
- The inadequate margin rate was comparable between SLR-Subseg (18.4%) and SLR-Seg (19.2%) groups (P=0.84).
- SLR-Subseg involved resecting fewer subsegments (median 2) compared to SLR-Seg (median 3) (P<0.001).
- Five-year relapse-free survival rates were equivalent (99.0% vs. 97.7%, P=0.22), with similar findings in propensity score-matched cohorts.
Conclusions:
- SLR-Subseg provides comparable surgical margin adequacy to SLR-Seg for early-stage lung cancer.
- SLR-Subseg demonstrates a significant advantage in preserving pulmonary parenchyma by resecting fewer subsegments.
- This technique represents a viable lung-sparing approach in early-stage lung cancer surgery.
