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Updated: May 26, 2026
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
Segmentectomy achieves comparable survival outcomes compared to lobectomy in peripheral ≤3 cm non-small cell lung
Yuting Chen1,2,3, Jie Wang1,2,3, Xusheng Ding1,2,3
1Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China.
Background:
While lobectomy remains the standard surgical approach for ≤3 cm non-small cell lung cancer (NSCLC), growing evidence suggests that segmentectomy offers comparable survival outcomes. However, whether segmentectomy provides similar prognostic benefit in patients with occult lymph node metastases remains unclear. This study aimed to compare the survival outcomes of segmentectomy versus lobectomy in peripheral ≤3 cm NSCLC patients with pathologically confirmed occult lymph node metastases.
Methods:
We retrospectively analyzed data of peripheral ≤3 cm cN0 NSCLC patients with pathologically confirmed pN1/2 disease treated at Shanghai Cancer Center between 2015 and 2023. Patients were categorized into segmentectomy and lobectomy groups. After 1:2 nearest-neighbor propensity score matching (PSM), clinical and prognostic outcomes were compared between the groups.
Results:
A total of 363 patients were included, and after 1:2 nearest-neighbor PSM, 71 patients who underwent segmentectomy and 112 who underwent lobectomy were selected for further study. Survival analysis showed no significant difference between the two groups in overall survival (P=0.53) and recurrence-free survival (P=0.78). Upon further investigation, subgroup analyses revealed no significant differences in survival across most clinical variables.
Conclusions:
Among patients with tumors ≤3 cm and occult lymph node metastases, segmentectomy can achieve survival outcomes comparable to lobectomy. These findings suggest that segmentectomy may be a viable surgical alternative in appropriately selected NSCLC patients with occult nodal involvement.
