Background: Computed tomography-guided dye localization facilitates extended segmentectomy with reliable oncologic margins for deep intersegmental early-stage lung cancer. This study evaluated perioperative and long-term outcomes in comparison with those of lobectomy. Methods: We retrospectively reviewed patients with early-stage lung adenocarcinoma ≤ 2 cm who underwent computed tomography-guided dye localization extended segmentectomy between 2013 and 2019 and compared them with those who underwent lobectomy between 2011 and 2016. After 1:1 propensity score matching based on demographic and clinical variables, 30 matched pairs were included in the analysis. Results: Compared with lobectomy, extended segmentectomy with computed tomography-guided dye localization was associated with shorter operative time (102 ± 34 vs. 181 ± 42 min, p < 0.001), less blood loss (0 0–0 vs. 0 0–62.5 mL, p < 0.001), shorter chest tube duration (1 1–2 vs. 2 2–3 d, p = 0.002), reduced hospital stay (3 3–4 vs. 5 4–6 d, p < 0.001), and smaller ipsilateral (10.4 1.9–15.7 vs. 20.0 10.0–26.2 %, p = 0.004) and total (1.3 −3.5–6.4 vs. 6.5 1.4–12.9 %, p = 0.022) lung volume reductions at 6 months. All patients achieved negative resection margins. Lymph node yield was lower in the segmentectomy group (p < 0.001); however, the 5-year overall and disease-free survival rates were comparable. Conclusions: Computed tomography-guided dye localization extended segmentectomy provides favorable perioperative and functional outcomes and achieves comparable oncologic control in selected patients with deep intersegmental early-stage lung adenocarcinoma, representing a potential alternative to lobectomy.
Lee et al. (Tue,) studied this question.