尽管亚肺叶切除（楔形切除[Wed]或肺段切除[Seg]）已成为日本临床IA1和IA2期非小细胞肺癌（NSCLC）的标准手术方式，但该手术对预后和术后并发症的影响本研究回顾性分析了2012年至2021年接受手术的470例临床分期≤ IA2 NSCLC患者的不良预后和术后并发症的危险因素。 (CTR) 高于 0.5，Wed 组 (72.1%) 的 5 年无复发生存率 (RFS) 显着低于 Seg (85.8%) 和 Lob (86.8%) 组 (p < 0.01) ，但Seg组和Lob组之间差异不显着。在 CTR 为 0.5 或更低的患者中，三组之间的 5 年 RFS 率没有显着差异。 RFS多变量分析显示，Wed组预后明显差于Lob组（风险比为2.83；p < 0.01），但Wed组与Seg组之间或Seg组与Lob组之间差异不显着。术后并发症的多变量分析显示，Wed 组的风险显着低于 Seg 组（比值比，0.31；p < 0.01）。Seg 可能成为临床 IA1 和 IA2 期 NSCLC 患者的标准手术方式。建议 CTR 为 0.5 或更低的患者选择周三，并具有避免术后并发症的优点。© 2024。外科肿瘤学会。

Although sublobar resection (wedge resection [Wed] or segmentectomy [Seg]) has become a standard operative procedure for clinical stages IA1 and IA2 non-small cell lung cancer (NSCLC) in Japan, the impact of this procedure on the prognosis and postoperative complications in real-world clinical practice is unknown.This study retrospectively analyzed risk factors for a poor prognosis and postoperative complications of 470 patients with clinical stage ≤ IA2 NSCLC who underwent surgery from 2012 to 2021.Among the patients with a consolidation-to-tumor ratio (CTR) higher than 0.5, the 5-year relapse-free survival (RFS) rate was significantly lower in the Wed group (72.1%) than in the Seg (85.8%) and Lob (86.8%) groups (p < 0.01), but the difference between the Seg and Lob groups was not significant. Among patients with a CTR of 0.5 or lower, the 5-year RFS rate did not differ significantly among the three groups. Multivariable analysis of RFS showed that the prognosis was significantly worse in the Wed group than in the Lob group (hazard ratio, 2.83; p < 0.01), but the difference between the Wed and Seg groups or the between Seg and Lob groups was not significant. Multivariable analysis of postoperative complications showed a significantly lower risk in the Wed group than in the Seg group (odds ratio, 0.31; p < 0.01).Seg could become the standard operative procedure for clinical stages IA1 and IA2 NSCLC patients. Wed is suggested to be an option for patients with a CTR of 0.5 or lower and has the advantage of avoiding postoperative complications.© 2024. Society of Surgical Oncology.