Work

Surgical outcomes of complex segmentectomy for clinical stage IA non-small cell lung cancer adjacent to the intersegmental plane between S6 and the basal segments

Year: 2026

Type: article

Abstract: Background: We investigated the clinical efficacy of complex segmentectomy for non-small cell lung cancer (NSCLC) adjacent to the intersegmental plane between S6 and the basal segments. Methods: Between 2009 and 2023, 135 patients with clinical stage IA NSCLC adjacent to the intersegmental plane in the lower lobe were retrospectively evaluated. We identified the intersegmental plane using three-dimensional (3D) image analysis systems and measured the distance (X) from the intersegmental plane to the tumor’s caudal side. Tumor location was classified into four: group A: located in S6, 10≤ X <20 mm; group B: located in S6, 0< X <10 mm; group C: on the plane (X=0); and group D: located in the basal segments. Clinicopathological characteristics, perioperative outcomes, and recurrence patterns were compared between S6 (n=123) and complex (n=12) segmentectomy. Results: Tumor distribution was 43 (32%) in group A, 35 (26%) in group B, 15 (11%) in group C, and 42 (31%) in group D. Complex segmentectomy was performed more frequently in group D (58% vs. 28%, p=0.03). Pure-solid tumors were more frequent in the complex segmentectomy group (42% vs. 20%, p = 0.07). Operative time was longer in complex segmentectomy than that in S6 segmentectomy (142 vs. 132 min, p=0.07); however, postoperative complications were similar between the two procedures (grade ≥3: 8% vs. 11%). Local recurrence occurred in three patients, which was exclusive to S6 segmentectomy. Conclusions: Complex segmentectomy may be considered in selected cases to secure adequate surgical margins based on preoperative three-dimensional evaluation.

Source: Journal of Cardiothoracic Surgery

DOI: 10.1186/s13019-026-04739-w