European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Factors determining the feasibility of segmentectomy for central non-small cell lung cancer and construction of a predictive model.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhu Shusheng, Li Zhihua, Xu Wenzheng, Wu Weibing, Chen Liang
Аннотация
OBJECTIVES: Multiple studies have demonstrated that segmentectomy is feasible and can yield long-term outcomes comparable to lobectomy for selected central non-small cell lung cancer (NSCLC). This study aimed to identify factors influencing the feasibility of segmentectomy for central NSCLC, and to develop a predictive nomogram.
METHODS: Patients with central NSCLC ≤2 cm who underwent segmentectomy or lobectomy between 2020 and 2024 were screened. Patients were split into two groups based on their surgical date (Training set: 2020-2023 and Validation set: 2024). The least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analyses were performed to identify potential predictors. Qualified segmentectomy (surgical margin ≥ maximum tumor diameter) was classified as 0, while lobectomy or unqualified segmentectomy was classified as 1. A nomogram was developed based on these identified predictors.
RESULTS: There were 303 and 105 patients in the training set and validation set, respectively. The probability of achieving sufficient margins during segmentectomy was 83.9 % in the training set and 81.3 % in the validation set. After LASSO and multivariable logistic regression analyses, four variables were retained: tumor size (OR = 3.81, P = 0.006), radiological type (solid vs. subsolid, OR = 5.39, P = 0.009), tumor-to-segmental bronchus distance (OR = 0.64, P = 0.036), and number of tumor-involved subsegments (OR = 1.54, P < 0.001). The nomogram developed from these predictors exhibited good predictive ability, with an area under the curve of 0.793 in the training set and 0.777 in the validation set.
CONCLUSIONS: Tumor size, radiological type, tumor-to-segmental bronchus distance, and number of tumor-involved subsegments influenced the feasibility of segmentectomy for central NSCLC.
METHODS: Patients with central NSCLC ≤2 cm who underwent segmentectomy or lobectomy between 2020 and 2024 were screened. Patients were split into two groups based on their surgical date (Training set: 2020-2023 and Validation set: 2024). The least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analyses were performed to identify potential predictors. Qualified segmentectomy (surgical margin ≥ maximum tumor diameter) was classified as 0, while lobectomy or unqualified segmentectomy was classified as 1. A nomogram was developed based on these identified predictors.
RESULTS: There were 303 and 105 patients in the training set and validation set, respectively. The probability of achieving sufficient margins during segmentectomy was 83.9 % in the training set and 81.3 % in the validation set. After LASSO and multivariable logistic regression analyses, four variables were retained: tumor size (OR = 3.81, P = 0.006), radiological type (solid vs. subsolid, OR = 5.39, P = 0.009), tumor-to-segmental bronchus distance (OR = 0.64, P = 0.036), and number of tumor-involved subsegments (OR = 1.54, P < 0.001). The nomogram developed from these predictors exhibited good predictive ability, with an area under the curve of 0.793 in the training set and 0.777 in the validation set.
CONCLUSIONS: Tumor size, radiological type, tumor-to-segmental bronchus distance, and number of tumor-involved subsegments influenced the feasibility of segmentectomy for central NSCLC.