Prognosis of segmentectomy and lobectomy for clinical T1c solid-dominant lung cancer

Sep 29, 2026

Uploaded by Ezra

Optimal surgical extent for clinical T1c solid-dominant non-small cell lung cancer (NSCLC) remains controversial. This retrospective study compared segmentectomy versus lobectomy in 888 patients with clinical T1c solid-dominant NSCLC (tumor diameter 2–3 cm; consolidation-to-tumor ratio >0.5). Five-year recurrence-free survival (RFS) and overall survival (OS) were assessed using propensity score matching (1:1) and subgroup Cox regression. Segmentectomy showed higher 5-year OS and RFS, with OS significant overall.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Background and rationale

Methods

Study design and patient selection

Survival endpoints and statistical analysis

Results

Overall survival

Recurrence-free survival

Conclusions

Clinical implications

Prognosis of segmentectomy and lobectomy for clinical T1c solid-dominant lung cancer Ziyao Zhang1,2,3\#, Fangqiu Fu1,2,3\#, Xiangze Li1,2,3\#, Yang Zhang1,2,3, Haiquan Chen1,2,3 1Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China; 2Institute of Thoracic Oncology, Fudan University, Shanghai, China; 3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China Contributions: (I) Conception and design: Z Zhang, Y Zhang, H Chen; (II) Administrative support: Y Zhang, H Chen; (III) Provision of study materials or patients: Z Zhang, F Fu, X Li; (IV) Collection and assembly of data: Z Zhang, X Li; (V) Data analysis and interpretation: Z Zhang, Y Zhang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. \#These authors contributed equally to this work. Correspondence to: Haiquan Chen, MD; Yang Zhang, MD. Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai 200032, China; Institute of Thoracic Oncology, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, [China. Email: hqchen1@yahoo.com](China. Email: hqchen1@yahoo.com); [fduzhangyang1987@hotmail.com](fduzhangyang1987@hotmail.com). Background: The optimal surgical extent for clinical T1c solid-dominant non-small cell lung cancer (NSCLC) remains debated. This study aimed to compare the recurrence-free survival (RFS) and overall survival (OS) between segmentectomy and lobectomy in patients with clinical T1c solid-dominant NSCLC. Methods: We retrospectively analyzed 888 patients with clinical T1c solid-dominant NSCLC [tumor diameter: 2–3 cm; consolidation-to-tumor ratio (CTR) >0.5] who underwent segmentectomy of the dominant pulmonary segment or lobectomy. Clinical characteristics, 5-year RFS, and 5-year OS were evaluated. Propensity score matching (PSM, 1:1) and subgroup Cox regression models were employed to adjust for confounders. Results: Of the 888 eligible cases, segmentectomy and lobectomy were performed in 55 and 833 patients, respectively. The difference in the 5-year OS between segmentectomy and lobectomy was found to be statistically significant (91.7% vs. 84.3%, P=0.02), which was also showed in the propensity score analysis (91.7% vs. 90.0%; P=0.08), with a median follow-up time of 46 months. The 5-year RFS did differ significantly between segmentectomy and lobectomy (89.46% vs. 71.50%; P=0.02), but it shown no difference in the propensity score analysis (89.46% vs. 81.5%; P=0.26) . Conclusions: The results indicate that segmentectomy of dominant pulmonary segment is superior to lobectomy in terms ofOS for solid-dominant NSCLC cases with a tumor diameter between 2 and 3 cm. Keywords: Segmentectomy; lobectomy; solid-dominant; clinical T1c; lung cancer Submitted Sep 15, 2025. Accepted for publication Nov 10, 2025. Published online Dec 29, 2025. doi: 10.21037/tlcr-2025-1068 View this article at: [https://dx.doi.org/10.21037/tlcr-2025-1068](https://dx.doi.org/10.21037/tlcr-2025-1068) Introduction The cornerstone of treatment for early-stage non-small cell lung cancer (NSCLC) remains radical lobectomy, a procedure involving en bloc resection of the affected pulmonary lobe, ipsilateral hilar lymph nodes, and mediastinal lymph node dissection to ensure oncological radicality. In 1995, Ginsberg and Rubinstein conducted a randomized controlled clinical trial comparing lobectomy to local resection for early stage lung cancer with nodules ≤ 3 cm in diameter (1) . Although the study established lobectomy as a superior radical treatment, it was unable to demonstrate the non-inferiority of sublobectomy due to limitations in case enrollment criteria and surgical instruments available at that time. © AME Publishing Company. Transl Lung Cancer Res 2025;14(1

FAQs

What clinical population was included in this study?

Patients with clinical T1c solid-dominant NSCLC were included, with tumor diameter 2–3 cm and consolidation-to-tumor ratio greater than 0.5.

Which treatment strategies were compared?

The study compared segmentectomy of the dominant pulmonary segment with lobectomy for clinical T1c solid-dominant NSCLC.

What were the main findings for overall survival and recurrence-free survival?

Segmentectomy showed a statistically significant improvement in 5-year overall survival versus lobectomy in the overall analysis. Five-year recurrence-free survival was also higher for segmentectomy, though the propensity score analysis did not show a significant difference.

Sep 29, 2026

Uploaded by Ezra