{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:14:17Z","timestamp":1794014057013,"version":"4.8.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>While recent randomized controlled trials have demonstrated that sublobar resection (SLR) is non-inferior to lobectomy, the comparative efficacy of these procedures remains uncertain for early-stage non-small cell lung cancer (NSCLC;\u00a0\u22643 cm) exhibiting invasive features postoperatively, such as visceral pleural invasion (VPI) or spread through air spaces (STAS).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods:<\/jats:title>\n            <jats:p>To identify eligible studies, a comprehensive search of PubMed, Embase, MEDLINE, the Cochrane Library, and Web of Science was conducted through 25 July 2024. Studies were screened according to predefined criteria in accordance with PRISMA guidelines. The primary endpoints were 5-year overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) and 95% confidence intervals (CI) were used to perform a meta-analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The final analysis included 14 retrospective studies and 1 randomized controlled trial, encompassing a total of 8054 patients with NSCLC (tumors \u22643 cm) exhibiting VPI or STAS. The meta-analysis revealed that SLR was associated with impaired 5-year OS (HR: 1.25; 95% CI: 1.10\u20131.41) and slightly inferior RFS (HR: 1.25; 95% CI: 0.99\u20131.58) compared to lobectomy for pT2a (VPI) NSCLC patients with tumor \u22643 cm. Similarly, SLR was associated with significantly worse 5-year OS (HR: 2.58; 95% CI: 1.92\u20133.45) and 5-year RFS (HR: 2.42; 95% CI: 1.69\u20133.46) compared to lobectomy for stage IA NSCLC patients with STAS. Subgroup analysis revealed that statistically significant differences in 5-year OS (HR: 1.13; 95% CI: 0.92\u20131.38) and 5-year RFS (HR: 0.87; 95% CI: 0.56\u20131.36) were not observed between the SLR and lobectomy groups for pT2a (VPI) NSCLC patients with tumor \u22642 cm. Additionally, no statistically significant survival difference was observed between the segmentectomy and lobectomy groups for NSCLC patients (\u22643 cm) with VPI (5-year OS: HR: 1.16; 95% CI: 0.89\u20131.52; 5-year RFS: HR: 1.07; 95% CI: 0.88\u20131.30) or STAS (5-year OS: HR: 3.88; 95% CI: 0.82\u201318.31; 5-year RFS: HR: 1.64; 95% CI: 0.70\u20133.80).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>For early-stage (\u22643 cm) NSCLC with VPI or STAS, SLR was associated with worse survival outcomes compared to lobectomy. However, segmentectomy achieved survival outcomes comparable to those of lobectomy. For pT2a (VPI) NSCLC patients with tumor \u22642 cm, the differences in survival outcomes between SLR and lobectomy were not statistically significant.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/js9.0000000000002249","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T11:00:07Z","timestamp":1738148407000},"page":"2675-2685","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":17,"title":["Could less be enough: sublobar resection vs lobectomy for clinical stage IA non-small cell lung cancer patients with visceral pleural invasion or spread through air spaces"],"prefix":"10.1097","volume":"111","author":[{"given":"Zhang-Yi","family":"Dai","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, West China hospital, SiChuan University, Chengdu, 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