Resection of 4 or more pulmonary segments increases the risk of non-cancer-related mortality.

This study analyzed the impact of the number of resected pulmonary segments on surgical outcomes and prognosis in patients undergoing anatomical pulmonary resection for non-small-cell lung cancer (NSCLC). Patients were divided into two groups based on resection of ≤3 segments (group A) or ≥4 segments (group B), with propensity score matching applied to control for preoperative factors including sarcopenia and osteoporosis. While surgical outcomes such as operation time and complications did not differ significantly, group B exhibited significantly greater declines in postoperative pulmonary function (vital capacity and forced expiratory volume in 1 second) and a higher incidence of non-cancer-related deaths, particularly among male patients. No significant differences were found in cancer recurrence or lung cancer-specific mortality between groups, highlighting the need for careful postoperative management in patients undergoing more extensive lung resections.