Factors Determine the Feasibility and Surgical Margin Quality of Sublobar Resection for Non-small Cell Lung Cancer?

Non-Small Cell Lung Cancer

Non-small cell lung cancer, Segmentectomy, Wedge resection, Margin quality

Sublobar resection (SR) has been recognized as non-inferior to lobectomy for small-sized non-small cell lung cancer (NSCLC). This study aimed to systematically identify the potential factors influencing the feasibility and surgical margin quality of SR for small-sized NSCLC. Patients with small-sized NSCLC (≤2 cm) who underwent SR or lobectomy between 2020 and 2023 were screened. Surgical procedures were determined by discussion under the guidance of 3D-CTBA. A surgical margin ≥ the maximum tumor diameter was considered sufficient. SR with a sufficient surgical margin was considered eligible. Univariate and multivariate logistic regression analyses were performed to identify factors affecting the feasibility and margin quality of SR.

Patients with small-sized pulmonary nodules who underwent lobectomy or SR between 2020 and 2023 in a single surgical team were retrospectively screened. All the surgical approach was jointly determined by three experienced surgeons (at least 15 years, Doctor Liang Chen, Weibing Wu and Zhicheng He). Patients satisfied with the following criteria were initially reserved: (1) the maximum nodule diameter ≤ 2 cm; (2) single malignant nodule; (3) intentional resection; (4) histopathological confirmed primary NSCLC. Further, patients with (1) interlobar lesions; (2) nodules in the right middle lobe; (3) receiving neoadjuvant before surgery; (4) poor CT quality were excluded.

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China