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Oncological Outcome of Minimally Invasive Single-Port Segmentectomy Compared to Lobectomy for Stage IA Lung Cancer

Title: Oncological Outcome of Minimally Invasive Single-Port Segmentectomy Compared to Lobectomy for Stage IA Lung Cancer
Authors: Boris Kostovski; Konstantinos Gioutsos; Michail Galanis; Francine Binelli; Thanh-Long Nguyen; Patrick Dorn
Source: Cancers ; Volume 17 ; Issue 21 ; Pages: 3431
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2025
Collection: MDPI Open Access Publishing
Subject Terms: non-small cell lung cancer; segmentectomy; lobectomy; uniportal VATS; early-stage lung cancer; stage IA3
Description: Background and Objectives: Lobectomy has traditionally been the gold standard for surgical treatment of early-stage non-small cell lung cancer (NSCLC). However, recent randomized trials suggest anatomical segmentectomy may offer comparable outcomes for selected patients with small, peripheral tumors. The role of segmentectomy in stage IA3 tumors remains less apparent in the context of video-assisted thoracoscopic surgery. Methods: This retrospective study analyzed 232 patients with pathological stage IA NSCLC who underwent uniportal anatomical segmentectomy (n = 160) or lobectomy (n = 72). Clinicopathological characteristics, recurrence rates, and overall survival (OS) were compared, with subgroup analysis for IA1–IA3 tumors. Results: The 5-year OS was 76.9% for segmentectomy and 87.5% for lobectomy (p = 0.105). Recurrence occurred in 15.8% of segmentectomy patients and 11.3% of lobectomy patients. In IA3 tumors, recurrence rates were higher after segmentectomy (23.5% vs. 18.2%), though not statistically significant. Lymphatic invasion was an independent predictor of mortality. No significant differences were found in tumor size, histologic subtype, or nodal involvement between groups. Conclusions: Uniportal anatomical segmentectomy may be a feasible alternative to lobectomy for stage IA NSCLC, especially for tumors ≤ 2 cm. For IA3 tumors, caution is advised given a trend toward worse outcomes. Careful patient selection and adherence to oncologic principles are essential.
Document Type: text
File Description: application/pdf
Language: English
Relation: Cancer Therapy; https://dx.doi.org/10.3390/cancers17213431
DOI: 10.3390/cancers17213431
Availability: https://doi.org/10.3390/cancers17213431
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.CCD86D8E
Database: BASE