{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:20:36Z","timestamp":1787062836397,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005111","name":"Rigshospitalet","doi-asserted-by":"publisher","award":["R163-A7357-B5343"],"award-info":[{"award-number":["R163-A7357-B5343"]}],"id":[{"id":"10.13039\/501100005111","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF22OC0079013"],"award-info":[{"award-number":["NNF22OC0079013"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed to evaluate the risk of unforeseen nodal upstaging (pN+) after pulmonary segmentectomy without intraoperative frozen section.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis for consecutive patients who underwent segmentectomy for clinical stage IA1-2 non-small cell lung cancer (cIA1-2 NSCLC) in three centers between January 2017 and December 2022. A backward stepwise logistic regression analysis for variables with\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.1 in univariable analysis was performed to predict pN+. Kaplan\u2013Meier analysis with log-rank test evaluated the discrepancy for overall (OS) and recurrence-free survivals (RFS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 478 patients included in the final analysis, 19 (4.0%) had pN+, including 10 (2.1%) pN1, 6 (1.3%) pN2, and 3 (0.6%) pN1+2. With a median follow-up of 23.5\u00a0months (interquartile range 12.6\u201339.0), patients with pN+ had poorer OS compared to those with pN0 (3-year OS: 70.2% vs. 89.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). However, there was no significant difference in RFS and recurrence. The maximum standardized uptake value (SUVmax) of tumor in positron emission tomography scan\u2009\u2265\u20094.5 (versus\u2009&lt;\u20094.5) was the only independent factor for pN\u2009+\u2009(odds ratio 3.5). Patients with a SUVmax\u2009\u2265\u20094.5 had 7.3% pN+, which was associated with poorer OS and similar RFS and recurrence compared to pN0. In contrast, those with a SUVmax\u2009&lt;\u20094.5 had 2.2% pN+, which had comparable recurrence and survival to pN0.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unforeseen nodal upstaging in segmentectomy for cIA1-2 NSCLC is low. Frozen section of lymph nodes may be necessary for lesions with high metabolic activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-11612-9","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T17:09:09Z","timestamp":1739466549000},"page":"2296-2303","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unforeseen nodal upstaging in patients undergoing segmentectomy without frozen section: a multicenter retrospective cohort study"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6768-1141","authenticated-orcid":false,"given":"Lin","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6505-1656","authenticated-orcid":false,"given":"Alessandro","family":"Brunelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demetrios","family":"Stefanou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Zanfrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abid","family":"Donlagic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8705-4279","authenticated-orcid":false,"given":"Michel","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-1869","authenticated-orcid":false,"given":"Ren\u00e9 Horsleben","family":"Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"11612_CR1","unstructured":"National Comprehensive Cancer Network (2023) NCCN guidelines version 1. 2024 non-small cell lung cancer. https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/nscl.pdf. 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Alessandro Brunelli reports speakers and advisory board fees for Astra Zeneca, BMS, MSD, Ethicon, Medtronic, Medela, and Roche. Michel Gonzalez reports speaker fees from Ethicon and Medtronic. The other authors have no conflict of interest to report. Lin Huang, Demetrios Stefanou, Edoardo Zanfrini, and Abid Donlagic have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}