¿Es la resección sublobar óptima para nódulos periféricos ≤2 cm con componentes histológicos micropapilares o...

The optimal extent of resection for small peripheral nonmucinous invasive lung adenocarcinoma with high-risk histologic features remains uncertain. Although sublobar resection is increasingly accepted for selected early-stage tumors, its adequacy for nonmucinous invasive lung adenocarcinoma harboring micropapillary or solid histologic components are not well defined.

We conducted a retrospective single-center cohort study of 501 patients with peripheral non-mucinous invasive lung adenocarcinoma ≤2 cm (pN0M0) containing micropapillary or solid histologic components who underwent lobectomy or sublobar resection between 2018 and 2020. Recurrence-free survival (RFS) and lung cancer-specific survival (LCSS) were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Propensity-score matching was performed as a sensitivity analysis to adjust for baseline differences.

Lobectomy was associated with higher 5-year RFS and LCSS compared with sublobar resection (log-rank p<0.001). These associations remained consistent after propensity-score matching. In matched analyses, consolidation-to-tumor ratio (CTR) >0.5, visceral pleural invasion, wedge resection, and segmentectomy were independently associated with worse LCSS and RFS compared with lobectomy.

In this single-center retrospective cohort, lobectomy was associated with more favorable outcomes than sublobar resection among ≤ 2 cm peripheral nonmucinous invasive lung adenocarcinoma harboring micropapillary or solid histology components. However, these findings are hypothesis-generating and require prospective validation.