Related Experiment Video
Updated: May 26, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Comparative outcomes of lobectomy and combined segmentectomy in left upper-lobe lung cancer: a propensity
Naoki Takeno1, Shunsuke Nomura2, Haruhiko Shiiya1
1Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Background:
Anatomically, the upper division and lingula of the left upper lobe correspond to the right upper lobe and right middle lobe. We aimed to compare long‑term oncologic outcomes of lobectomy and combined segmentectomy (tri-segmentectomy or lingulectomy) for left upper‑lobe lung cancer.
Methods:
We retrospectively reviewed patients who underwent either procedure at two institutions between January 2012 and December 2017. We analyzed the 5‑year overall survival (OS) rate, recurrence‑free survival (RFS) rate, and patterns of local and distant recurrence. Propensity‑score matching (1:1) was used to balance baseline characteristics.
Results:
Among 247 eligible patients (lobectomy: 191; combined segmentectomy: 56), matching produced 53 well‑balanced pairs. OS and RFS were comparable between both groups (5-year OS: 93.7% vs. 87.9%, P=0.44; 5-year RFS: 85.6% vs. 85.3%, P=0.93). Local and distant recurrence rates showed no significant differences. Subgroup analyses limited to clinical node-negative disease (5-year OS: 93.6% vs. 87.7%, P=0.44; 5-year RFS: 85.2% vs. 84.9%, P=0.93) and tumors >2 cm with a consolidation‑to‑tumor ratio >0.5 (5-year OS: 82.6% vs. 76.0%, P=0.85; 5-year RFS: 62.8% vs. 77.0%, P=0.30) showed comparable outcomes.
Conclusions:
Tri-segmentectomy or lingulectomy provides oncologic outcomes comparable with those of lobectomy while preserving lung parenchyma in selected patients with left upper-lobe lung cancer. Prospective trials are needed to confirm these findings and identify patients who derive the greatest benefit.
