Surgical Treatment of Elderly NSCLC Patients: Long-term Outcomes from a Single-Center Cohort.

OBJECTIVES:The management of non-small cell lung cancer (NSCLC) in elderly patients is an increasing clinical challenge. This study compared postoperative and oncologic outcomes between anatomical and wedge resections in patients aged ≥75 years. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Secondary endpoints included predictors of postoperative complications and survival. METHODS:This retrospective study included 393 patients aged ≥75 years who underwent surgery for NSCLC between 2010 and 2019. Among them, 103 underwent wedge resection and 290 anatomical resection. Demographic, clinical, surgical, and oncologic data were collected. Multivariate analyses identified predictors of complications, OS, and DFS. RESULTS:Patients undergoing wedge resection were older and had higher comorbidity scores but experienced shorter operative times and fewer complications. Five-year OS and DFS were 53.2% and 56.8%, respectively, with no significant differences between groups. Reduced FEV1, open surgery, and longer operative time independently predicted postoperative complications. Male sex, higher comorbidity burden, smoking, reduced FEV1, and postoperative complications were associated with worse OS. CONCLUSIONS:Wedge resection represents a safe alternative to anatomical resection in selected elderly patients, with comparable survival outcomes and reduced perioperative burden. Careful preoperative selection remains essential.