# Wedge resection versus segmentectomy in peripheral clinical stage IA lung cancer concerning ground-glass opacity

## TL;DR

This study compares wedge resection and segmentectomy for early-stage lung cancer and finds similar outcomes for part-solid tumors but better results with segmentectomy for solid tumors.

## Contribution

The study identifies that tumor composition, specifically ground-glass opacity, influences the effectiveness of sublobar resection techniques in lung cancer.

## Key findings

- For part-solid tumors, wedge resection and segmentectomy showed similar 5-year disease-free survival and recurrence rates.
- For solid tumors, segmentectomy outperformed wedge resection in terms of disease-free survival and recurrence rates.
- Tumor composition (part-solid vs. solid) significantly affects the outcomes of sublobar resection techniques.

## Abstract

Recent randomized controlled trials have shown the non-inferiority of sublobar-to-lobar resection for small peripheral non-small cell lung cancer (NSCLC); however, whether wedge resection (WR) or anatomical segmentectomy (SG) is superior remains unclear. We hypothesized that ground-glass opacity (GGO) is associated with the outcomes of WR and SG.

Between 2010 and 2022, 219 consecutive patients with clinical stage IA peripheral NSCLC who underwent sublobar resection for frailty at our institution were retrospectively reviewed. Based on the high-resolution computed tomography findings, the tumors were classified into two groups: part-solid (GGO (+)) and solid (GGO (−)). The long-term outcomes were compared between the WR and SG groups.

In the part-solid group (n = 124; median CTR, 0.62), WR was equivalent to SG in terms of 5-year disease-free survival [DFS] (98% vs. 91%; p = 0.2) and recurrence rate (0% vs. 4.3%; p = 0.3). In the solid tumor group (n = 95), WR was inferior to SG in terms of the 5-year DFS (43% vs. 80%; p < 0.01) and recurrence rate (32% vs. 3.7%; p < 0.01).

In our study population, WR was not inferior to SG for part-solid tumors. However, for solid tumors, the long-term outcomes of SG are superior to those of WR.

The online version contains supplementary material available at 10.1007/s00595-025-03137-4.