Current real-life survival after segmentectomy for lung cancer

Segmentectomy for non-small cell lung cancer (NSCLC) is increasingly performed for small-sized lesions. However, prognostic factors associated with poor outcomes after this lung-sparing oncologic surgery remain uncertain.

We conducted a single-center retrospective study including 100 consecutive patients who underwent single or multiple segmentectomies for NSCLC in real-world practice.

In univariate analyses, compromise segmentectomy (HR 3.52; p = 0.005), complex segmentectomy (HR 2.56; p = 0.020), SUVmax ≥ 6 (HR 2.86; p = 0.017), and thoracotomy (HR 2.62; p = 0.020) were associated with worse overall survival. In multivariable analysis, compromise segmentectomy remained associated with worse overall survival (HR 3.47; p = 0.026). Regarding recurrence, thoracotomy was associated with poorer disease-free survival (HR 2.77; p = 0.040).

In this real-world cohort, compromise segmentectomy identified a high-risk subgroup with impaired overall survival, probably reflecting baseline frailty and comorbidity rather than a clearly demonstrated increase in recurrence. These findings support careful preoperative selection and counseling of patients considered for lung-sparing resection outside standard indications.