Comparison of segmentectomy and lobectomy for non-small cell lung cancer with visceral pleural invasion

In patients with VPI-positive lung cancer, segmentectomy may offer a better prognosis for those with tumors measuring < 2 cm. Nevertheless, lobectomy should be considered first for patients with tumors measuring > 2 cm. Our study provides novel insights by stratifying outcomes based on tumor size, highlighting pleural dissemination risk and death causes, which may support individualized surgical decision-making. Although no statistically significant difference was found, lobectomy may be more appropriate for patients with tumors > 2 cm based on the observed recurrence patterns and potential for better local control.