我们的目标是比较T1c（>2-3 cm）放射学纯实性非小细胞肺癌在薄层计算机断层扫描中检测到的节段切除术和肺叶切除术的结果。本回顾性研究比较了c-T1cN0M0 放射学纯实性非小细胞肺癌患者中节段切除术和肺叶切除术的生存结果、死亡原因和复发模式。进行了多变量分析以控制干扰生存的因素。采用Kaplan-Meier方法分析总生存和无复发生存率。使用Gray方法评估不同组别间复发的累积发生率。共有426名患者，其中381名接受肺叶切除术，45名接受节段切除术。104名患者（24.4%）存在淋巴结转移。多变量分析结果显示肺叶切除术是较好的OS独立预测因子（HR 0.596，95% CI 0.366-0.969，p = 0.037）。肺叶切除组显示有利的5年总生存率和无复发生存率（总生存率：72.9% vs 59.7%，log-rank检验p = 0.007；无复发生存率：64.4% vs 48.7%，p = 0.034）（中位随访：53个月）。肺叶切除组约有14%的患者和节段切除组约有27%的患者因肺癌死亡。此外，节段切除组的5年局部区域复发累积发生率显著较高（35.5% vs 15.8%，p < 0.001）。在T1c放射学纯实性非小细胞肺癌中，节段切除术与较差的生存率和不充分的局部区域肿瘤控制显著相关。肺叶切除术仍然是标准的外科治疗方法；与此同时，应该非常谨慎地应用节段切除术。© 2023年作者。由牛津大学出版社代表欧洲心胸外科协会发布。

We aimed to compare the outcomes of segmentectomy with those of lobectomy in T1c (>2-3 cm) radiological pure-solid non-small cell lung cancer detected on thin-section computed tomography.This retrospective review compared the survival outcomes, causes of death, and recurrence patterns between the segmentectomy and lobectomy in patients with c-T1cN0M0 radiological pure-solid non-small cell lung cancer. Multivariable analysis was performed to control for confounders of survival. The overall survival and recurrence-free survival were analyzed using the Kaplan-Meier method. Differences in cumulative incidence of recurrence between groups were assessed using the methods of Gray.Of the 426 patients, lobectomy was performed in 381 patients and segmentectomy in 45 patients. Nodal metastasis was noted in 104 (24.4%) patients. Multivariable analysis revealed that lobectomy was an independent prognosticator of better OS (HR 0.596, 95% CI 0.366-0.969, p = 0.037). Lobectomy arm showed favourable 5-year overall survival and recurrence-free survival (overall survival: 72.9% vs 59.7%, log-rank test p = 0.007; recurrence-free survival: 64.4% vs 48.7%, p = 0.034) (median follow-up: 53 months). Approximately 14% of the patients in the lobectomy group and 27% in the segmentectomy group died of lung cancer. Furthermore, 5-year cumulative incidence of loco-regional recurrence rate was significantly higher in the segmentectomy group (35.5% vs 15.8%, p < 0.001).In T1c radiological pure-solid non-small cell lung cancer, segmentectomy was significantly associated with worse survival and insufficient loco-regional cancer control. Lobectomy remains the standard surgical treatment; meanwhile, segmentectomy should be applied with great caution.© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.