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.
**背景与目的：** 肺叶切除术历来是早期非小细胞肺癌（NSCLC）外科治疗的金标准。然而，近期随机试验表明，对于特定的小型周围型肿瘤患者，解剖性肺段切除术可能提供相当的疗效。在电视辅助胸腔镜手术背景下，肺段切除术在IA3期肿瘤中的作用仍不明确。 **方法：** 本研究回顾性分析了232例病理分期为IA期的NSCLC患者，其中160例接受单孔解剖性肺段切除术，72例接受肺叶切除术。比较两组的临床病理特征、复发率及总生存期（OS），并对IA1–IA3亚组进行分析。 **结果：** 肺段切除术组的5年OS为76.9%，肺叶切除术组为87.5%（p=0.105）。肺段切除术组复发率为15.8%，肺叶切除术组为11.3%。在IA3期肿瘤中，肺段切除术后的复发率较高（23.5% vs. 18.2%），但无统计学显著性。淋巴侵犯是死亡风险的独立预测因素。两组在肿瘤大小、组织学亚型或淋巴结转移方面均无显著差异。 **结论：** 对于IA期NSCLC（尤其是肿瘤≤2 cm者），单孔解剖性肺段切除术可能是肺叶切除术的可行替代方案。对于IA3期肿瘤，鉴于其疗效可能较差的趋势，建议谨慎选择。严格的病例筛选及遵循肿瘤学原则至关重要。
肿瘤(癌症)患者之家