Does Location Matter? Impact of Tumor Location (Peripheral vs Central) on Surgical Outcomes of Segmentectomy in Early Stage NSCLC: A Meta-Analysis

Mada Ilham Bawono, Mohammad Rizky Ariesto, Belinda Mufidah, Mada Dwi Hari

Abstract

Introduction: Recent studies recommend segmentectomy for early-stage peripheral NSCLC due to better lung parenchyma preservation; however, its role in early-stage central NSCLC remains debated. This study aims to analyze the impact of tumor location (peripheral vs central) on segmentectomy outcomes in early-stage NSCLC.

Methods: Only studies comparing segmentectomy outcomes by tumor location (peripheral vs central) in early-stage (T1a–cN0M0) NSCLC will be included. Studies involving lobectomy, wedge resection, or more advanced stages will be excluded. We registered the study protocol on PROSPERO (CRD420251127645). Article searches will be conducted in PubMed, Scopus, and Web of Science. All databases were last searched on 16 August 2025. Risk of bias will be assessed using the Newcastle–Ottawa Scale. Data will be analyzed with RevMan 5.4 and presented as forest plots.

Result: Five cohort studies were included, comprising a total 2,134 participants (1,499 peripheral and 635 central tumours) were included. The meta-analysis findings indicated that there were no significant differences between peripheral and central tumor locations regarding 5-year overall survival, recurrence-free survival, recurrence patterns, or intraoperative blood loss. However, segmentectomy performed for peripheral tumors resulted in a significantly shorter operative duration compared with procedures for central tumors (SMD −0.20; 95% CI −0.30 to −0.10; p < 0.0001).

Conclusion: This study has limitations due to the small sample size and study design, which affect its generalizability. Nevertheless, the analysis results indicate that segmentectomy is also a choice of treatment for early-stage central NSCLC.

Keywords

Central; Non-Small Cell Lung Cancer; Peripheral; Segmentectomy

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DOI: https://doi.org/10.13057/smj.v9i1.115488

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