Research advances in sublobar resection for early-stage non small cell lung cancer

doi:10.3877/cma.j.issn.2095-8773.2025.03.06

Abstract

Abstract:

The results of the randomized controlled trials, Japan Clinical Oncology Group (JCOG) 0802 and Cancer and Leukemia Group B (CALGB) 140503, have demonstrated that sublobar resection offers comparable prognosis to lobectomy for patients with early-stage non-small cell lung cancer (NSCLC) with tumors ≤2 cm in diameter. However, the application of sublobar resection in clinical practice remains controversial. This review summarizes these controversies into four key points: the impact of high-risk pathological factors on the safety of sublobar resection, lymph node dissection during sublobar resection, factors influencing local recurrence in sublobar resection, and the benefits to quality of life from sublobar resection. We summarize the research progress on these controversies to provide insights for the clinical application of sublobar resection.

Key words: Sublobar resection, High-risk pathological factors, Lymph node dissection, Local recurrence, Quality of life

Yutao Chen, Jianfei Shen, Dehua Ma. Research advances in sublobar resection for early-stage non small cell lung cancer[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2025, 12(03): 162-175.

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References 139

1	Bray F，Laversanne M，Sung H，et al．Global cancer statistics 2022：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]．CA Cancer J Clin，2024，74（3）：229-263．
2	Ginsberg RJ，Rubinstein LV．Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group[J]．Ann Thorac Surg，1995，60（3）：615-622．
3	Goya T，Asamura H，Yoshimura H，et al．Prognosis of 6644 resected non-small cell lung cancers in Japan：a Japanese lung cancer registry study[J]．Lung Cancer，2005，50（2）：227-234．
4	Saji H，Okada M，Tsuboi M，et al．Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer（JCOG0802/WJOG4607L）：a multicentre，open-label，phase 3，randomised，controlled，non-inferiority trial[J]．Lancet，2022，399（10335）：1607-1617．
5	Altorki N，Wang X，Kozono D，et al．Lobar or Sublobar Resection for Peripheral Stage ⅠA Non-Small-Cell Lung Cancer[J]．N Engl J Med，2023，388（6）：489-498．
6	Higgins KA，Chino JP，Ready N，et al．Lymphovascular invasion in non-small-cell lung cancer：implications for staging and adjuvant therapy[J]．J Thorac Oncol，2012，7（7）：1141-1147．
7	Mollberg NM，Bennette C，Howell E，et al．Lymphovascular invasion as a prognostic indicator in stage Ⅰ non-small cell lung cancer：a systematic review and meta-analysis[J]．Ann Thorac Surg，2014，97（3）：965-971．
8	Han YB，Kim H，Mino-Kenudson M，et al．Tumor spread through air spaces（STAS）：prognostic significance of grading in non-small cell lung cancer[J]．Mod Pathol，2021，34（3）：549-561．
9	Sato T，Shimada Y，Mimae T，et al．The impact of pathological lymph node metastasis with lymphatic invasion on the survival of patients with clinically node-negative non-small cell lung cancer：A multicenter study[J]．Lung Cancer，2021，158：9-14．
10	Tsutani Y，Suzuki K，Koike T，et al．High-Risk Factors for Recurrence of Stage Ⅰ Lung Adenocarcinoma：Follow-up Data From JCOG0201[J]．Ann Thorac Surg，2019，108（5）：1484-1490．
11	Kagimoto A，Tsutani Y，Shimada Y，et al．Oncological outcome of segmentectomy for early-stage non-small-cell lung cancer with invasive characteristics：a multicentre study[J]．Eur J Cardiothorac Surg，2022，62（2）：ezac055．
12	Akamine T，Wakasu S，Matsubara T，et al．[J]．Ann Surg Oncol，2025，32（6）：4161-4172．
13	Ding H，Song N，Zhang P，et al．Wedge resection plus adequate lymph nodes resection is comparable to lobectomy for small-sized non-small cell lung cancer[J]．Front Oncol，2022，12：1022904．
14	Ling L，Zheng H，Lin H，et al．Adequate Number of Lymph Nodes Sampled May Determine Appropriate Surgical Modality for Early-Stage NSCLC：A Population-Based Real-World Study[J]．Clin Lung Cancer，2023，24（3）：e141-e151．
15	Stiles BM，Mao J，Harrison S，et al．Extent of lymphadenectomy is associated with oncological efficacy of sublobar resection for lung cancer ≤2 cm[J]．J Thorac Cardiovasc Surg，2019，157（6）：2454-2465.e1．
16	Ruan Z，Zhuo X，Xu C．Diagnosis，treatment，and prognosis of Stage ⅠB non-small cell lung cancer with visceral pleural invasion[J]．Front Oncol，2023，13：1310471．
17	Choi SY，Moon MH，Moon Y．The prognosis of small-sized non-small cell lung cancer with visceral pleural invasion after sublobar resection[J]．Transl Cancer Res，2020，9（10）：6431-6443．
18	Yu Y，Huang R，Wang P，et al．Sublobectomy versus lobectomy for long-term survival outcomes of early-stage non-small cell lung cancer with a tumor size ≤2 cm accompanied by visceral pleural invasion：a SEER population-based study[J]．J Thorac Dis，2020，12（3）：592-604．
19	Huang W，Deng HY，Lin MY，et al．Treatment Modality for Stage ⅠB Peripheral Non-Small Cell Lung Cancer With Visceral Pleural Invasion and ≤3 cm in Size[J]．Front Oncol，2022，12：830470．
20	Whitehorn GL，Rshaidat H，Madeka I，et al．Lobectomy Is Not Associated With Improved Survival as Compared to Segmentectomy in Early-Stage Lung Cancer Patients With Visceral Pleural Invasion[J]．Clin Lung Cancer，2025，26（2）：e99-e107.e10．
21	Mathey-Andrews C，Abruzzo AR，Venkateswaran S，et al．Segmentectomy vs Lobectomy for Early Non-Small Cell Lung Cancer With Visceral Pleural Invasion[J]．Ann Thorac Surg，2024，117（5）：1007-1014．
22	Lula Lukadi J，Mariolo AV，Ozgur EG，et al．Upstaged from cT1a-c to pT2a lung cancer, related to visceral pleural invasion patients, after segmentectomy：is it an indication to complete resection to lobectomy?[J]．Interdiscip Cardiovasc Thorac Surg，2023，37（4）：ivad102．
23	Travis WD，Brambilla E，Noguchi M，et al．International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma[J]．J Thorac Oncol，2011，6（2）：244-285．
24	Cha MJ，Lee HY，Lee KS，et al．Micropapillary and solid subtypes of invasive lung adenocarcinoma：clinical predictors of histopathology and outcome[J]．J Thorac Cardiovasc Surg，2014，147（3）：921-928.e2．
25	Travis WD，Brambilla E，Nicholson AG，et al. The 2015 World Health Organization Classification of Lung Tumors：Impact of Genetic，Clinical and Radiologic Advances Since the 2004 Classification[J]. J Thorac Oncol，2015，10（9）：1243-1260.
26	Nitadori J，Bograd AJ，Kadota K，et al．Impact of micropapillary histologic subtype in selecting limited resection vs lobectomy for lung adenocarcinoma of 2cm or smaller[J]．J Natl Cancer Inst，2013，105（16）：1212-1220．
27	Su H，Xie H，Dai C，et al．Procedure-specific prognostic impact of micropapillary subtype may guide resection strategy in small-sized lung adenocarcinomas：a multicenter study[J]．Ther Adv Med Oncol，2020，12：1758835920937893．
28	Xu L，Zhou H，Wang G，et al．The prognostic influence of histological subtypes of micropapillary tumors on patients with lung adenocarcinoma ≤ 2 cm[J]．Front Oncol，2022，12：954317．
29	Yao J，Zhu E，Li M，et al. Prognostic Impact of Micropapillary Component in Patients with Node-Negative Subcentimeter Lung Adenocarcinoma：A Chinese Cohort Study[J]. Thorac Cancer，2020，11（12）：3566-3575.
30	Jeon YJ，Lee J，Shin S，et al．Prognostic impact of micropapillary and solid histological subtype on patients undergoing curative resection for stage Ⅰ lung adenocarcinoma according to the extent of pulmonary resection and lymph node assessment[J]．Lung Cancer，2022，168：21-29．
31	Moreira AL，Ocampo PSS，Xia Y，et al．A Grading System for Invasive Pulmonary Adenocarcinoma：A Proposal From the International Association for the Study of Lung Cancer Pathology Committee[J]．J Thorac Oncol，2020，15（10）：1599-1610．
32	Wang S，Zhang B，Qian J，et al．Proposal on incorporating lymphovascular invasion as a T-descriptor for stage Ⅰ lung cancer[J]．Lung Cancer，2018，125：245-252．
33	Yun JK，Lee GD，Choi S，et al．Comparison of prognostic impact of lymphovascular invasion in stage ⅠA non-small cell lung cancer after lobectomy versus sublobar resection：A propensity score-matched analysis[J]．Lung Cancer，2020，146：105-111．
34	Ma L，Sullivan TB，Rieger-Christ KM，et al．Vascular invasion predicts the subgroup of lung adenocarcinomas≤2.0 cm at risk of poor outcome treated by wedge resection compared to lobectomy[J]．JTCVS Open，2023，16：938-947．
35	Gross DJ，Hsieh MS，Li Y，et al．Spread Through Air Spaces（STAS） in Non-Small Cell Lung Carcinoma：Evidence Supportive of an In Vivo Phenomenon[J]．Am J Surg Pathol，2021，45（11）：1509-1515．
36	Eguchi T，Kameda K，Lu S，et al．Lobectomy Is Associated with Better Outcomes than Sublobar Resection in Spread through Air Spaces（STAS）-Positive T1 Lung Adenocarcinoma：A Propensity Score-Matched Analysis[J]．J Thorac Oncol，2019，14（1）：87-98．
37	Kadota K，Nitadori JI，Sima CS，et al．Tumor Spread through Air Spaces is an Important Pattern of Invasion and Impacts the Frequency and Location of Recurrences after Limited Resection for Small Stage Ⅰ Lung Adenocarcinomas[J]．J Thorac Oncol，2015，10（5）：806-814．
38	Kadota K，Kushida Y，Katsuki N，et al．Tumor Spread Through Air Spaces Is an Independent Predictor of Recurrence-free Survival in Patients With Resected Lung Squamous Cell Carcinoma[J]．Am J Surg Pathol，2017，41（8）：1077-1086．
39	Li J，Wang Y，Li J，et al．Meta-analysis of Lobectomy and Sublobar Resection for Stage Ⅰ Non-small Cell Lung Cancer With Spread Through Air Spaces[J]．Clin Lung Cancer，2022，23（3）：208-213．
40	徐奕，陈东来，徐学君，等．气腔播散对手术决策的影响及冰冻切片识别气腔播散准确性的系统评价与meta分析[J]．中国胸心血管外科临床杂志，2024，31（6）：900-909．
41	Kagimoto A，Tsutani Y，Kushitani K，et al．Segmentectomy vs Lobectomy for Clinical Stage ⅠA Lung Adenocarcinoma With Spread Through Air Spaces[J]．Ann Thorac Surg，2021，112（3）：935-943．
42	Ikeda T，Kadota K，Go T，et al．Segmentectomy Provides Comparable Outcomes to Lobectomy for Stage ⅠA Non-small Cell Lung Cancer with Spread through Air Spaces[J]．Semin Thorac Cardiovasc Surg，2023，35（1）：156-163．
43	Huang L，Petersen RH．Tumour spread through air spaces is a determiner for treatment of clinical stage Ⅰ non-small cell lung Cancer：Thoracoscopic segmentectomy vs lobectomy[J]．Lung Cancer，2025，201：108438．
44	Si H，Xu L，Zhao Y，et al．Spread Through Air Spaces in Residual Tumor Classification for ClinicalⅠA Lung Adenocarcinoma[J]．Ann Thorac Surg，2024，118（4）：825-833．
45	Trivedi NP，Ravindran HK，Sundram S，et al．Pathologic evaluation of sentinel lymph nodes in oral squamous cell carcinoma[J]．Head Neck，2010，32（11）：1437-1443．
46	Lutfi W，Schuchert MJ，Dhupar R，et al．Node-Positive Segmentectomy for Non-Small-Cell Lung Cancer：Risk Factors and Outcomes[J]．Clin Lung Cancer，2019，20（4）：e463-e469．
47	Razi SS，Nguyen D，Villamizar N．Lobectomy does not confer survival advantage over segmentectomy for non-small cell lung cancer with unsuspected nodal disease[J]．J Thorac Cardiovasc Surg，2020，159（6）：2469-2483．
48	Kneuertz PJ，Abdel-Rasoul M，D'Souza DM，et al．Wedge Resection vs Lobectomy for Clinical Stage ⅠA Non-Small Cell Lung Cancer With Occult Lymph Node Disease[J]．Ann Thorac Surg，2023，115（6）：1344-1351．
49	Nobel TB，Tan KS，Adusumilli PS，et al．Outcomes of Patients Undergoing Segmentectomy for Occult Node-Positive Clinical Stage ⅠA Lung Cancer[J]．Ann Thorac Surg，2024，118（3）：655-663．
50	Luo X，Hayanga JWA，Mehaffey JH，et al．Clinical Stage ⅠA non-small cell lung cancer with occult pathologic N1 and N2 disease after segmentectomy：does a completion lobectomy justify?[J]．Eur J Cardiothorac Surg，2024，66（5）：ezae415．
51	Ren Y，Xie H，Dai C，et al．Prognostic Impact of Tumor Spread Through Air Spaces in Sublobar Resection for 1A Lung Adenocarcinoma Patients[J]．Ann Surg Oncol，2019，26（6）：1901-1908．
52	Thomas PA．Lymph node dissection during sublobar resection：why，when and how?[J]．J Thorac Dis，2018，10（Suppl 10）：S1145-S1150．
53	Matsumura Y，Hishida T，Yoshida J，et al．Reasonable extent of lymph node dissection in intentional segmentectomy for small-sized peripheral non-small-cell lung cancer：from the clinicopathological findings of patients who underwent lobectomy with systematic lymph node dissection[J]．J Thorac Oncol，2012，7（11）：1691-1697．
54	Nomori H，Ohba Y，Shibata H，et al．Required area of lymph node sampling during segmentectomy for clinical stage ⅠA non-small cell lung cancer[J]．J Thorac Cardiovasc Surg，2010，139（1）：38-42．
55	Xiao F，Yu Q，Zhang Z，et al．Novel perspective to evaluate the safety of segmentectomy：clinical significance of lobar and segmental lymph node metastasis in cT1N0M0 lung adenocarcinoma[J]．Eur J Cardiothorac Surg，2018，53（1）：228-234．
56	Maniwa T，Okami J，Miyoshi T，et al．Lymph node dissection in small peripheral lung cancer：Supplemental analysis of JCOG0802/WJOG4607L[J]．J Thorac Cardiovasc Surg，2024，168（3）：674-683.e1．
57	Suzuki K，Koike T，Asakawa T，et al．A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical ⅠA lung cancer（Japan Clinical Oncology Group 0201）[J]．J Thorac Oncol，2011，6（4）：751-756．
58	Asamura H，Hishida T，Suzuki K，et al．Radiographically determined noninvasive adenocarcinoma of the lung：survival outcomes of Japan Clinical Oncology Group 0201[J]．J Thorac Cardiovasc Surg，2013，146（1）：24-30．
59	Suzuki K，Watanabe SI，Wakabayashi M，et al．A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer[J]．J Thorac Cardiovasc Surg，2022，163（1）：289-301.e2．
60	Aokage K，Suzuki K，Saji H，et al．Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity（JCOG1211）：a multicentre，single-arm，confirmatory，phase 3 trial[J]．Lancet Respir Med，2023，11（6）：540-549．
61	Okada M，Sakamoto T，Yuki T，et al．Selective mediastinal lymphadenectomy for clinico-surgical stage Ⅰ non-small cell lung cancer[J]．Ann Thorac Surg，2006，81（3）：1028-1032．
62	Asamura H，Nakayama H，Kondo H，et al．Lobe-specific extent of systematic lymph node dissection for non-small cell lung carcinomas according to a retrospective study of metastasis and prognosis[J]．J Thorac Cardiovasc Surg，1999，117（6）：1102-1111．
63	Lardinois D，De Leyn P，Van Schil P，et al．ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer[J]．Eur J Cardiothorac Surg，2006，30（5）：787-792．
64	Eckardt J，Jakobsen E，Licht PB. Subcarinal Lymph Nodes Should be Dissected in All Lobectomies for Non-Small Cell Lung Cancer-Regardless of Primary Tumor Location[J]. Ann Thorac Surg，2017，103（4）：1121-1125.
65	Xu C，Sun J，Liu H，et al．Analysis of the lymph node metastasis distribution in patients with invasive resectable non-small cell lung cancer[J]．Transl Lung Cancer Res，2024，13（11）：3039-3049．
66	Zhang Y，Deng C，Zheng Q，et al．Selective Mediastinal Lymph Node Dissection Strategy for Clinical T1N0 Invasive Lung Cancer：A Prospective，Multicenter，Clinical Trial[J]．J Thorac Oncol，2023，18（7）：931-939．
67	Hishida T，Saji H，Watanabe SI，et al．A randomized Phase III trial of lobe-specific vs. systematic nodal dissection for clinical Stage Ⅰ~Ⅱ non-small cell lung cancer（JCOG1413）[J]．Jpn J Clin Oncol，2018，48（2）：190-194．
68	Nakagawa K，Watanabe SI，Wakabayashi M，et al．Risk Factors for Locoregional Relapse After Segmentectomy：Supplementary Analysis of the JCOG0802/WJOG4607L Trial[J]．J Thorac Oncol，2025，20（2）：157-166．
69	Stamatis G，Leschber G，Schwarz B，et al．Survival outcomes in a prospective randomized multicenter Phase Ⅲ trial comparing patients undergoing anatomical segmentectomy versus standard lobectomy for non-small cell lung cancer up to 2 cm[J]．Lung Cancer，2022，172：108-116．
70	Huang L，Petersen RH．Impact of Margin Distance on Locoregional Recurrence and Survival After Thoracoscopic Segmentectomy[J]．Ann Thorac Surg，2025，119（2）：316-324．
71	Mohiuddin K，Haneuse S，Sofer T，et al．Relationship between margin distance and local recurrence among patients undergoing wedge resection for small（≤2 cm） non-small cell lung cancer[J]．J Thorac Cardiovasc Surg，2014，147（4）：1169-1175；discussion 1175-1177．
72	Wolf AS，Swanson SJ，Yip R，et al．The Impact of Margins on Outcomes After Wedge Resection for Stage Ⅰ Non-Small Cell Lung Cancer[J]．Ann Thorac Surg，2017，104（4）：1171-1178．
73	Altorki N，Wang X，Damman B，et al．Lobectomy，segmentectomy，or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer：A post hoc analysis of CALGB 140503（Alliance）[J]．J Thorac Cardiovasc Surg，2024，167（1）：338-347.e1．
74	Fourdrain A，Anastay V，Pauly V，et al．Peripheral location of lung cancer is associated with higher local disease recurrence[J]．Eur J Cardiothorac Surg，2023，63：ezad130．
75	Fourdrain A，Lafitte S，Iquille J，et al．Lymphatic drainage of lung segments in the visceral pleura：a cadaveric study[J]．Surg Radiol Anat，2018，40（1）：15-19．
76	Fourdrain A，Epailly J，Blanchard C，et al．Lymphatic drainage of lung cancer follows an intersegmental pathway within the visceral pleura[J]．Lung Cancer，2021，154：118-123．
77	Handa Y，Tsutani Y，Mimae T，et al．Complex segmentectomy in the treatment of stage ⅠA non-small-cell lung cancer[J]．Eur J Cardiothorac Surg，2020，57（1）：114-121．
78	Saijo T，Ishii G，Nagai K，et al．Differences in clinicopathological and biological features between central-type and peripheral-type squamous cell carcinoma of the lung[J]．Lung Cancer，2006，52（1）：37-45．
79	Moon Y，Lee KY，Sung SW，et al．Differing histopathology and prognosis in pulmonary adenocarcinoma at central and peripheral locations[J]．J Thorac Dis，2016，8（1）：169-177．
80	Handa Y，Tsutani Y，Tsubokawa N，et al．Clinical Prognosis of Superior Versus Basal Segment Stage Ⅰ Non-Small Cell Lung Cancer[J]．Ann Thorac Surg，2017，104（6）：1896-1901．
81	Jones GD，Caso R，Choe G，et al．Intentional Segmentectomy for Clinical T1 N0 Non-small Cell Lung Cancer：Survival Differs by Segment[J]．Ann Thorac Surg，2021，111（3）：1028-1035．
82	Watanabe S，Suzuki K，Asamura H．Superior and basal segment lung cancers in the lower lobe have different lymph node metastatic pathways and prognosis[J]．Ann Thorac Surg，2008，85（3）：1026-1031．
83	Wu X，Li T，Zhang C，et al．Comparison of Perioperative Outcomes Between Precise and Routine Segmentectomy for Patients With Early-Stage Lung Cancer Presenting as Ground-Glass Opacities：A Propensity Score-Matched Study[J]．Front Oncol，2021，11：661821．
84	Ontiveros N，Eapen-John D，Osorio N，et al．Predicting Lung Function Following Lobectomy：A New Method to Adjust for Inherent Selection Bias[J]．Respiration，2018，96（5）：434-445．
85	Gu Z，Wang H，Mao T，et al．Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery[J]．J Thorac Dis，2018，10（4）：2331-2337．
86	Tane S，Nishio W，Nishioka Y，et al．Evaluation of the Residual Lung Function After Thoracoscopic Segmentectomy Compared With Lobectomy[J]．Ann Thorac Surg，2019，108（5）：1543-1550．
87	Kim SJ，Lee YJ，Park JS，et al．Changes in pulmonary function in lung cancer patients after video-assisted thoracic surgery[J]．Ann Thorac Surg，2015，99（1）：210-217．
88	Ohtani-Kim SJ，Samejima J，Wakabayashi M，et al．Effect of Resected Lung Volume on Pulmonary Function and Residual Lung Volume in Patients Undergoing Segmentectomy：A Retrospective Study[J]．Ann Surg Oncol，2024，31（10）：6645-6651．
89	Wakamatsu I，Matsuguma H，Nakahara R，et al．Factors associated with compensatory lung growth after pulmonary lobectomy for lung malignancy：an analysis of lung weight and lung volume changes based on computed tomography findings[J]．Surg Today，2020，50（2）：144-152．
90	Ito T，Suzuki H，Wada H，et al．Concordant pattern of radiologic，morphologic，and genomic changes during compensatory lung growth[J]．J Surg Res，2017，212：60-67．
91	Asakura K，Izumi Y，Kohno M，et al．Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment：comparison between staplers and scissors in ex vivo pig lung[J]．Eur J Cardiothorac Surg，2011，40（1）：e34-e38．
92	Seok Y，Cho S，Lee JY，et al．The effect of postoperative change in bronchial angle on postoperative pulmonary function after upper lobectomy in lung cancer patients[J]．Interact Cardiovasc Thorac Surg，2014，18（2）：183-188．
93	Ueda K，Tanaka T，Hayashi M，et al．Clinical ramifications of bronchial kink after upper lobectomy[J]．Ann Thorac Surg，2012，93（1）：259-265．
94	Nomori H，Cong Y，Sugimura H．Systemic and regional pulmonary function after segmentectomy[J]．J Thorac Cardiovasc Surg，2016，152（3）：747-753．
95	Dai J，Sun F，Bao M，et al．Pulmonary Function Recovery and Displacement Patterns After Anatomic Segmentectomy vs Lobectomy[J]．Ann Thorac Surg，2024，118（2）：365-374．
96	Chen L，Gu Z，Lin B，et al．Pulmonary function changes after thoracoscopic lobectomy versus intentional thoracoscopic segmentectomy for early-stage non-small cell lung cancer[J]．Transl Lung Cancer Res，2021，10（11）：4141-4151．
97	Ichimura H，Kobayashi K，Gosho M，et al．Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery[J]．Surg Today，2024，54（2）：195-204．
98	Stamatis G，Leschber G，Schwarz B，et al．Perioperative course and quality of life in a prospective randomized multicenter phase Ⅲ trial，comparing standard lobectomy versus anatomical segmentectomy in patients with non-small cell lung cancer up to 2 cm，Stage ⅠA（7th edition of TNM staging system）[J]．Lung Cancer，2019，138：19-26．
99	Brunelli A，Tariq J，Mittal A，et al．Self-reported dyspnoea and shortness of breathing deterioration in long-term survivors after segmentectomy or lobectomy for early-stage lung cancer[J]．Eur J Cardiothorac Surg，2024，65：ezae200．
100	Dai W，Chang S，Pompili C，et al．Early Postoperative Patient-Reported Outcomes After Thoracoscopic Segmentectomy Versus Lobectomy for Small-Sized Peripheral Non-small-cell Lung Cancer[J]．Ann Surg Oncol，2022，29（1）：547-556．
101	Zhao Y，Liu W，Gao X，et al．Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer[J]．J Cardiothorac Surg，2024，19（1）：215．
102	Fernando HC，Landreneau RJ，Mandrekar SJ，et al．Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer：results from the ACOSOG Z4032（Alliance） multicenter randomized trial[J]．J Thorac Cardiovasc Surg，2015，149（3）：718-725．
103	Jiang S，Wang B，Zhang M，et al．Quality of life after lung cancer surgery：sublobar resection versus lobectomy[J]．BMC Surg，2023，23（1）：353．
104	Lin R，Chen W，Zhu L，et al．Comparison of postoperative cough-related quality of life and recovery between sublobectomy and lobectomy for early-stage non-small cell lung cancer patients：a longitudinal study[J]．BMC Pulm Med，2022，22（1）：154．
105	Onodera K，Suzuki J，Miyoshi T，et al．Comparison of various lung intersegmental plane identification methods[J]．Gen Thorac Cardiovasc Surg，2023，71（2）：90-97．
106	Funai K，Kawase A，Shimizu K，et al．Fluorescence navigation with indocyanine green for identification of intersegmental planes using a photodynamic eye camera[J]．J Thorac Dis，2020，12（9）：4817-4824．
107	Sun Y，Zhang Q，Wang Z，et al．Is the near-infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation-deflation method in lung segmentectomy?[J]．Thorac Cancer，2019，10（10）：2013-2021．
108	Cai L，Wang C，Luo T，et al．Delineation of intersegmental plane：application of blood flow blocking method in pulmonary segmentectomy[J]．J Cardiothorac Surg，2024，19（1）：684．
109	Li Y，Cao Y，Chen Y，et al．Comparison of watershed analysis with indocyanine green fluorescence staining and modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy[J]．J Thorac Dis，2024，16（11）：7697-7708．
110	Altorki N，Wang X，Damman B，et al．Recurrence of Non-Small Cell Lung Cancer With Visceral Pleural Invasion：A Secondary Analysis of a Randomized Clinical Trial[J]．JAMA Oncol，2024，10（9）：1179-1186．
111	Yang Z，Li Y，Guo C，et al．The prognostic value of visceral pleural infiltration in≤3 cm nonsmall cell lung cancer presenting with ground glass opacity: an inverse probability of treatment weighting study[J]．Int J Surg，2024，110（12）：7871-7879．
112	Choe J，Lee SM，Park S，et al．The prognostic value of lymphovascular invasion for Stage Ⅰ lung adenocarcinoma based on the presence of ground-glass opacity[J]．Eur Radiol，2025，35（4）：2256-2264．
113	Ding Y，Zhao S，Liu X，et al．The value of frozen section diagnosis of tumor spread through air spaces in small-sized （≤ 2 cm） non-small cell lung cancer[J]. World J Surg Oncol，2023，21（1）：195．
114	Xu SJ，Tu JH，Chen H，et al．A Multi-institutional Analysis of the Combined Effect of Micropapillary Component and Consolidation-to-Tumor Ratio >0.5 on the Prognosis of Pathological，Stage ⅠA3，Lung Adenocarcinoma[J]．Ann Surg Oncol，2023，30（9）：5843-5853．
115	Zhu M，Xu Y，Huang J，et al．Sublobar resection for lung adenocarcinoma less than 2 cm containing solid or micropapillary components radiologically presented as consolidation-to-tumor ratio（CTR）≤0.25 [ground-glass opacity（GGO）][J]．Transl Lung Cancer Res，2024，13（7）：1685-1694．
116	Wu Y，Jin K，Qin L，et al．Safety and efficacy of delayed completion lobectomy following wedge resection vs. segmentectomy-a retrospective cohort study[J]．J Thorac Dis，2024，16（4）：2379-2393．
117	Detterbeck F，Ely S，Udelsman B，et al．So Now We Know-Reflections on the Extent of Resection for Stage Ⅰ Lung Cancer[J]．Clin Lung Cancer，2024，25（3）：e113-e123．
118	Cao H，Zheng Q，Deng C，et al．Prediction of Spread Through Air Spaces（STAS） By Intraoperative Frozen Section for Patients with cT1N0M0 Invasive Lung Adenocarcinoma：A Multi-Center Observational Study（ECTOP-1016）[J/OL]．Ann Surg，2024，[Epub ahead of print]．
119	Fu Z，Shen X，Deng C，et al．Prediction of the pathological subtypes by intraoperative frozen section for patients with cT1N0M0 invasive lung adenocarcinoma（ECTOP-1015）：a prospective multicenter study[J]．Int J Surg，2024，110（9）：5444-5451．
120	Tang J，Cui Y，Li B，et al．Mathematical prediction model of computed tomography signs is superior to intraoperative frozen section in the diagnosis of ground-glass nodular invasive adenocarcinoma of the lung[J]．Thorac Cancer，2021，12（17）：2382-2387．
121	Takizawa H，Kondo K，Kawakita N，et al．Autofluorescence for the diagnosis of visceral pleural invasion in non-small-cell lung cancer[J]．Eur J Cardiothorac Surg，2018，53（5）：987-992．
122	Bossé Y，Dasgupta A，Abadier M，et al．Prognostic implication of methylation-based circulating tumor DNA detection prior to surgery in stage Ⅰ non-small cell lung cancer[J]．Cancer Lett，2024，594：216984．
123	Hong TH，Hwang S，Dasgupta A，et al．Clinical Utility of Tumor-Naïve Presurgical Circulating Tumor DNA Detection in Early-Stage NSCLC[J]．J Thorac Oncol，2024，19（11）：1512-1524．
124	Driussi A，Lamaze FC，Kordahi M，et al．Clinicopathological Predictors of the Presence of Blood Circulating Tumor DNA in Early-Stage Non-Small Cell Lung Cancers[J/OL]．Mod Pathol，2025，[Epub ahead of print]．
125	Karasaki T，Moore DA，Veeriah S，et al．Evolutionary characterization of lung adenocarcinoma morphology in TRACERx[J]．Nat Med，2023，29（4）：833-845．
126	Hong TH，Hwang S，Abbosh C，et al．Association of pre-surgical circulating tumor DNA detection，use of sublobar resection with risk of recurrence in stage Ⅰ non-small cell lung cancer[J]．Eur J Cancer，2025，217：115237．
127	Brunelli A，Decaluwe H，Gonzalez M，et al．European Society of Thoracic Surgeons expert consensus recommendations on technical standards of segmentectomy for primary lung cancer[J]．Eur J Cardiothorac Surg，2023，63：ezad224．
128	Tsuchiya T，Kamohara R，Muraoka M，et al．A single-arm，phase 2 study of adjuvant chemotherapy with oral tegafur-uracil for pathologically lymphovascular invasion positive stage ⅠA non-small cell lung cancer：LOGIK0602 study[J]．BMC Cancer，2020，20（1）：1192．
129	Li R，Qiu J，Li Z，et al．Prognostic significance and survival benefits of postoperative adjuvant chemotherapy in patients with stage ⅠA lung adenocarcinoma with non-predominant micropapillary components[J]．World J Surg Oncol，2024，22（1）：32．
130	Xie S，Liu Q，Han Y，et al．Adjuvant chemotherapy can benefit the survival of stage Ⅰ lung adenocarcinoma patients with tumour spread through air spaces after resection：Propensity-score matched analysis[J]．Front Oncol，2022，12：905958．
131	Libor L，Pécsy B，Szűcs E，et al．Effect of transbronchial or intravenous administration of indocyanine green on resection margins during near-infrared-guided segmentectomy：a review[J]．Front Surg，2024，11：1430100．
132	Ueda Y，Mitsumata S，Matsunaga H，et al．Use of a radiofrequency identification system for precise sublobar resection of small lung cancers[J]．Surg Endosc，2023，37（3）：2388-2394．
133	Shimada Y，Maehara S，Osawa J，et al．Powered articulation by the SigniaTM stapling system for stapling position adjustments: optimizing safe surgical margins in thoracoscopic sublobar resection[J]．Surg Today，2021，51（3）：447-451．
134	Lin YH，Chen LW，Wang HJ，et al．Quantification of Resection Margin following Sublobar Resection in Lung Cancer Patients through Pre- and Post-Operative CT Image Comparison：Utilizing a CT-Based 3D Reconstruction Algorithm[J]．Cancers（Basel），2024，16（12）：2181．
135	Knudsen JE，Ghaffar U，Ma R，et al．Clinical applications of artificial intelligence in robotic surgery[J]．J Robot Surg，2024，18（1）：102．
136	Martin JL，Mack SJ，Rshaidat H，et al．Wedge Resection Outcomes：A Comparison of Video-Assisted and Robot-Assisted Wedge Resections[J]．Ann Thorac Surg，2024，118（3）：683-690．
137	Maniwa T，Ohue M，Shintani Y，et al．Extent of Lymph Node Dissection in Patients with Small-Sized Peripheral Non-Small Cell Lung Cancer during Intentional Segmentectomy[J]．Ann Thorac Cardiovasc Surg，2023，29（6）：271-278．
138	Adachi H，Ito H，Nagashima T，et al．Mediastinal lymph node dissection in segmentectomy for peripheral c-stage ⅠA（≤2 cm） non-small-cell lung cancer[J]．J Thorac Cardiovasc Surg，2025，169（4）：1108-1119.e3．
139	Edwards T，Balata H，Elshafi M，et al．Adequacy of Intraoperative Nodal Staging during Surgical Resection of NSCLC：Influencing Factors and Its Relationship to Survival[J]．J Thorac Oncol，2017，12（12）：1845-1850．

作者	时间	地区	数据来源	患者数量	手术类型	病理类型	肿瘤分期		肿瘤大小（cm）	主要终点	随访时间（月）
作者	时间	地区	数据来源	患者数量	手术类型	病理类型	类型	分期	肿瘤大小（cm）	主要终点	随访时间（月）
Choi^[17]	2020	韩国	单中心	227	LR/SLR（206/21）	NSCLC	p	ⅠB	NR	OS/RFS	44.9
Yu^[18]	2020	美国	多中心	1 386	LR/SLR（1 000/386）	NSCLC	p	ⅠB	≤2	OS/DFS	58.0
Huang^[19]	2022	美国	多中心	1 993	LR/SR/WR（1 386/111/416）	NSCLC	p	ⅠB	≤3	OS	33.0
Lula Lukadi^[22]	2023	法国	多中心	253	LR/SR	NSCLC	p	ⅠB	≤3	OS/DFS	41.0
Mathey-Andrews^[21]	2024	美国	多中心	2 568	LR/SR（2 390/178）	NSCLC	p	ⅠB	≤2	OS	NA
Whitehorn^[20]	2025	美国	多中心	4 981	LR/SR（4 503/478）	NSCLC	p	ⅠB	≤2	OS	NA

作者	时间	地区	数据来源	患者数量	手术类型	病理类型	肿瘤分期		肿瘤大小（cm）	主要终点	随访时间（月）
作者	时间	地区	数据来源	患者数量	手术类型	病理类型	类型	分期	肿瘤大小（cm）	主要终点	随访时间（月）
Choi^[17]	2020	韩国	单中心	227	LR/SLR（206/21）	NSCLC	p	ⅠB	NR	OS/RFS	44.9
Yu^[18]	2020	美国	多中心	1 386	LR/SLR（1 000/386）	NSCLC	p	ⅠB	≤2	OS/DFS	58.0
Huang^[19]	2022	美国	多中心	1 993	LR/SR/WR（1 386/111/416）	NSCLC	p	ⅠB	≤3	OS	33.0
Lula Lukadi^[22]	2023	法国	多中心	253	LR/SR	NSCLC	p	ⅠB	≤3	OS/DFS	41.0
Mathey-Andrews^[21]	2024	美国	多中心	2 568	LR/SR（2 390/178）	NSCLC	p	ⅠB	≤2	OS	NA
Whitehorn^[20]	2025	美国	多中心	4 981	LR/SR（4 503/478）	NSCLC	p	ⅠB	≤2	OS	NA

作者	时间	地区	数据来源	患者数	手术类型	高级别成分含量	肿瘤分期		肿瘤大小（cm）	主要终点	随访时间（月）
作者	时间	地区	数据来源	患者数	手术类型	高级别成分含量	类型	分期	肿瘤大小（cm）	主要终点	随访时间（月）
Nitadori^[26]	2013	美国	单中心	734	LR/SLR（476/258）	≥5%	p	Ⅰ	≤2	CIR	NA
Yao^[29]	2020	中国	多中心	311	LR/SR/WR（232/38/41）	≥5%	c	Ⅰ	≤1	OS/RFS	NA
Su^[27]	2020	中国	多中心	772	LR/SR/WR（663/54/85）	≥5%	c	Ⅰ	≤2	OS/RFS	NA
Xu^[28]	2022	中国	单中心	390	LR/SLR（234/156）	≥5%	p	Ⅰ	≤2	OS	57.0
Jeon^[30]	2022	韩国	单中心	1 886	LR/SLR（1 486/400）	≥1%	p	Ⅰ	≤2	OS/RFS	NA

作者	时间	地区	数据来源	患者数	手术类型	高级别成分含量	肿瘤分期		肿瘤大小（cm）	主要终点	随访时间（月）
作者	时间	地区	数据来源	患者数	手术类型	高级别成分含量	类型	分期	肿瘤大小（cm）	主要终点	随访时间（月）
Nitadori^[26]	2013	美国	单中心	734	LR/SLR（476/258）	≥5%	p	Ⅰ	≤2	CIR	NA
Yao^[29]	2020	中国	多中心	311	LR/SR/WR（232/38/41）	≥5%	c	Ⅰ	≤1	OS/RFS	NA
Su^[27]	2020	中国	多中心	772	LR/SR/WR（663/54/85）	≥5%	c	Ⅰ	≤2	OS/RFS	NA
Xu^[28]	2022	中国	单中心	390	LR/SLR（234/156）	≥5%	p	Ⅰ	≤2	OS	57.0
Jeon^[30]	2022	韩国	单中心	1 886	LR/SLR（1 486/400）	≥1%	p	Ⅰ	≤2	OS/RFS	NA

作者	时间	地区	数据来源	患者数	手术类型	肿瘤类型	肿瘤分期		主要终点	随访时间（月）
作者	时间	地区	数据来源	患者数	手术类型	肿瘤类型	类型	分期	主要终点	随访时间（月）
Kaqimoto^[41]	2021	日本	单中心	293	LR/SR（186/107）	ADC	c	IA	OS/RFS	NA
Ikeda^[42]	2023	日本	单中心	148	LR/SR/WR（112/17/19）	NSCLC	p	IA	OS/RFS	60.5
Huang^[43]	2025	丹麦	单中心	151	LR/SR（135/16）	NSCLC	c	I	OS/RFS	19.2

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