Surgical strategy for non–small cell lung cancer in patients with chronic obstructive pulmonary disease: initial experience at Pham Ngoc Thach Hospital

Abstract

Background: Non–small cell lung cancer (NSCLC) frequently coexists with chronic obstructive pulmonary disease (COPD), increasing perioperative risks. Prospective evidence from Vietnam remains limited, particularly regarding outcomes across GOLD stages.

Methods: A prospective, single-center longitudinal observational study was conducted at Pham Ngoc Thach Hospital from October 2024 to September 2027. This report presents an interim analysis of 45 consecutive patients who underwent surgery between October 2024 and August 2025. Collected variables included demographic characteristics, pulmonary function parameters, surgical techniques, 30-day postoperative complications, length of hospital stay, and 30-day mortality. The findings were compared with data reported in the international literature published between 2014 and 2025.

Results: Mean age was 65.2 ± 7.4 years; 82.2% were male. Mean FEV₁ and DLCO were 61% and 64% of predicted. VATS was performed in 66.7% of cases. Postoperative complications occurred in 28.9% of patients (pneumonia 13.3%, prolonged air leak 8.9%). No 30-day mortality was observed. The median length of stay was 8 days, consistent with global reports (7, 9, 11).

Conclusions: Lobectomy appears safe and feasible in NSCLC patients with mild-to-moderate COPD, particularly when performed via minimally invasive approaches. Segmentectomy may further optimize lung preservation in small peripheral tumors.