NGHIÊN CỨU ĐẶC ĐIỂM BỆNH LÝ UNG THƯ PHỔI KHÔNG TẾ BÀO NHỎ GIAI ĐOẠN SỚM VÀ YẾU TỐ TIÊN LƯỢNG SAU PHẪU THUẬT Ở NGƯỜI CAO TUỔI TẠI BỆNH VIỆN THỐNG NHẤT

Abstract

Background: Non-small cell lung cancer (NSCLC) has become increasingly prevalent in Vietnam due to advances in screening and imaging techniques. However, curative surgery in elderly patients remains challenging owing to comorbidities, postoperative complications, and heterogeneity in biological age, pathological characteristics and prognostic outcomes following surgery in this population are still underreported. Subjects and Methods: A cross-sectional descriptive study was conducted on 56 elderly patients diagnosed with early-stage NSCLC who underwent surgical resection and follow-up at Thong Nhat Hospital between June 2018 and December 2024. The objective was to evaluate clinicopathological features and postoperative prognostic factors. Results and Discussion: The mean age was 72.8, with males accounting for 78.6%, and 44.6% having a history of smoking. Comorbidity was common (CCI ≥3 in 60.7%). Adenocarcinoma was the predominant histologic type (67.9%), with poor differentiation seen in 25%. Stage I disease accounted for 71.4% of cases. Factors significantly associated with postoperative complications included ASA class III or higher (p=0.04), CCI ≥3 (p=0.01), and open surgery (p=0.03). The 5-year disease-free survival (DFS) rate was 82.1%, and overall survival (OS) was 68%. With a median follow-up of 48.5 months, nodal metastasis (N2+), high CCI, and poorly differentiated tumors were independently associated with decreased 5-year survival based on Cox regression analysis. Conclusion: Surgical resection for early-stage NSCLC in elderly patients yields favorable survival outcomes when appropriate selection is applied. Adverse prognostic factors include postoperative N2 nodal positivity, poorly differentiated histology, and CCI ≥3. These findings may contribute to optimizing curative treatment strategies for elderly lung cancer patients.