# Dye Localization Extended Segmentectomy vs. Lobectomy for Deep Intersegmental Early-Stage Lung Cancer

## TL;DR

This study compares extended segmentectomy with lobectomy for early-stage lung cancer, finding similar survival but better short-term outcomes with segmentectomy.

## Contribution

Demonstrates that dye-guided extended segmentectomy offers comparable cancer control with better perioperative outcomes than lobectomy for deep intersegmental lung tumors.

## Key findings

- Extended segmentectomy had shorter operation time, less blood loss, and shorter hospital stays compared to lobectomy.
- Patients who underwent segmentectomy had smaller lung volume reductions at 6 months.
- Comparable 5-year survival rates were observed despite fewer lymph nodes harvested in segmentectomy cases.

## Abstract

Background: Computed tomography-guided dye localization facilitates extended segmentectomy with reliable oncologic margins for deep intersegmental early-stage lung cancer. This study evaluated perioperative and long-term outcomes in comparison with those of lobectomy. Methods: We retrospectively reviewed patients with early-stage lung adenocarcinoma ≤ 2 cm who underwent computed tomography-guided dye localization extended segmentectomy between 2013 and 2019 and compared them with those who underwent lobectomy between 2011 and 2016. After 1:1 propensity score matching based on demographic and clinical variables, 30 matched pairs were included in the analysis. Results: Compared with lobectomy, extended segmentectomy with computed tomography-guided dye localization was associated with shorter operative time (102 ± 34 vs. 181 ± 42 min, p < 0.001), less blood loss (0 [0–0] vs. 0 [0–62.5] mL, p < 0.001), shorter chest tube duration (1 [1–2] vs. 2 [2–3] d, p = 0.002), reduced hospital stay (3 [3–4] vs. 5 [4–6] d, p < 0.001), and smaller ipsilateral (10.4 [1.9–15.7] vs. 20.0 [10.0–26.2] %, p = 0.004) and total (1.3 [−3.5–6.4] vs. 6.5 [1.4–12.9] %, p = 0.022) lung volume reductions at 6 months. All patients achieved negative resection margins. Lymph node yield was lower in the segmentectomy group (p < 0.001); however, the 5-year overall and disease-free survival rates were comparable. Conclusions: Computed tomography-guided dye localization extended segmentectomy provides favorable perioperative and functional outcomes and achieves comparable oncologic control in selected patients with deep intersegmental early-stage lung adenocarcinoma, representing a potential alternative to lobectomy.