Related Experiment Video
Updated: May 5, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
European prognosis evaluation of early-stage lung adenocarcinoma patterns after lobectomy versus segmentectomy based
Lukadi Joseph Lula1,2, Lin Huang3,4, Clara Forcada Barreda5
1Service of Thoracic Surgery, Department of General Surgery, Sherbrooke University, Charles LeMoyne Hospital, Longueuil, Quebec, Canada.
Objectives:
To investigate the prognosis of peripheral early-stage lung adenocarcinoma patterns treated by lobectomy or segmentectomy.
Methods:
Retrospective multicentric cohort of patients with cT1a-bN0M0 lung adenocarcinoma who underwent lobectomy or segmentectomy with systematic lymph node dissection in 10 European centers (one per country) from 2015 to 2021. Overall survival (OS), disease-free survival (DFS), and lung cancer-specific death (LCSD) between both groups were assessed in entire dataset and in dataset of histologic aggressive patterns, before and after propensity score-matching (PSM). Prognostic risk factors were analyzed using parsimonious model Cox regression. Recurrences were assessed by linearized risks.
Results:
Lobectomy and segmentectomy were performed in 1029 (73.1%) and 377 (26.8%) patients, respectively. In total, 427 (30.3%) patients had at least 1 histologic aggressive (micropapillary or solid) pattern, and 88 patients (20.7%) underwent segmentectomy. OS, DFS, and LCSD rates were similar between patients who underwent lobectomy or segmentectomy, in both datasets, before and after PSM. In aggressive dataset, PSM, 5-year OS rates were lobectomy 88.0% (95% CI, 80.9-95.7%), segmentectomy 89.1% (95% CI, 82.2-96.6%), P = .8; 5-year DFS rates were lobectomy 79.8% (95% CI, 70.8-89.8%), segmentectomy 80.6% (95% CI, 71.6-90.6%), P = .6; and 5-year LCSD rates were lobectomy 6.0%, segmentectomy 7.8%, P = .8. Locoregional recurrence was not superior in patients who underwent segmentectomy in entire dataset (linearized risks: lobectomy 0.078, segmentectomy 0.073) and in aggressive dataset (linearized risks: lobectomy 0.036, segmentectomy 0.011) only in the unmatched cohorts. Aggressive histologic patterns impacted on only LCSD, and only when they were dominant.
Conclusions:
Segmentectomy seems comparable to lobectomy for patients with peripheral cT1a-bN0M0 lung adenocarcinoma even in case of histologic aggressive patterns.
