尽管同步多发性原发性肺癌(sMPLC)在临床实践中很常见，但对于主要病变的手术方式的选择仍处于探索阶段。这项研究旨在分析sMPLC和肿瘤分期类似的单一原发性肺癌的预后，并探讨亚叶切除与肺叶切除对sMPLC的预后是否相似。选择了包括以下病例的141例sMPLC:65例对主要病变进行肺叶切除，76例对主要病变进行亚叶切除。通过倾向评分匹配，1:1配对了1144例单发原发性肺癌。然后，根据第一肿瘤分期，将sMPLC的患者分为肺叶切除组和亚叶切除组。匹配了98例sMPLC患者的病例。比较了两组之间的短期围手术期效果、5年无病生存率(DSF)和5年总生存率(OS)。在肺叶切除(77.1% vs. 77.2%, P = 0.157)和亚叶切除(98.7% vs. 90.7%, P = 0.309)后，sMPLC和单发原发性肺癌之间的OS没有显著差异。sMPLC的肺叶切除组和亚叶切除组之间的OS (86.7% vs. 83.9%, P = 0.482)或DSF (67.6 vs. 87.7%, P = 0.324)没有显著差异。亚叶切除组的术后并发症发生率较低(40.8% vs. 16.3%, P = 0.007)，住院时间较短(11.22 vs. 9.27, P = 0.049)。sMPLC患者的预后通常取决于主要肿瘤状态，不论是亚叶切除还是肺叶切除，其统计学差异都不显著，并且亚叶切除的围手术期更安全。©2023.作者。

Although synchronous multiple primary lung cancers (sMPLCs) are common in clinical practice, the choice of surgical modalities for the main lesion is still at the stage of exploration. This study is designed to analyze the prognosis of sMPLCs and single primary lung cancers with similar tumor stages and to explore whether sublobar resection has a similar prognosis as lobectomy for sMPLCs.One-hundred forty-one cases of sMPLCs were selected, including the following: 65 cases underwent lobectomy for main lesions, and 76 cases underwent sublobar resection for main lesions. One thousand one hundred forty-four cases of single primary lung cancer were matched at 1:1 by propensity score matching. Then, the patients with sMPLCs were divided into a lobectomy group and a sublobar group according to the first tumor stage. Ninety-eight cases of patients with sMPLCs were matched. The short-term perioperative effect, 5-year disease-free survival (DFS) rate, and 5-year overall survival (OS) rate between the two groups were compared.There was no significant difference in OS between sMPLCs and single primary lung cancer after lobectomy (77.1% vs. 77.2%, P = 0.157) and sublobar resection (98.7% vs. 90.7%, P = 0.309). There was no significant difference in OS (86.7% vs. 83.9%, P = 0.482) or DFS (67.6 vs. 87.7%, P = 0.324) between the lobectomy group and sublobar group with sMPLCs. The sublobar resection group obtained a lower incidence of postoperative complications (40.8% vs. 16.3%, P = 0.007) and shorter postoperative hospital stay (11.22 vs. 9.27, P = 0.049).The prognosis of patients with sMPLCs generally depends on the main tumor state, which has no statistical difference regardless of sublobar resection or lobectomy, and the perioperative period of sublobar resection is safer than that of lobectomy.© 2023. The Author(s).