Surgical treatment of stage IA lung cancer in elderly and senile patients: balance between radicality and tolerability

Increased life expectancy and advances in modern medicine contribute to an annual increase in the number of people over 65. The incidence of most oncological diseases peaks among older age groups. Lung cancer is one of the most serious public health problems worldwide among the elderly. On the one hand, this disease is one of the commonest and most aggressive, requiring comprehensive treatment. On the other hand, choosing the appropriate surgical intervention for the elderly poses a difficult dilemma. From the perspective of oncological radicalism, lobectomy is considered the minimum acceptable surgical treatment for lung cancer. However, elderly and senile patients with comorbidities and geriatric syndromes often cannot undergo such an operation, which is the reason for refusing surgical intervention. In these cases, alternative non-surgical treatments are prescribed, but in most cases they are not sufficiently radical, leading to frequent and rapid relapses of the disease. Recently, thoracic surgeons have actively studied the applicability of sublobar resections for malignant lung pathology, and most scientific studies confirm that lobectomies are more effective than less extensive procedures. Only in rare cases of early-stage IA lung cancer can sublobar resection demonstrate comparable efficacy with lobectomy. The undoubted advantage of less extensive procedures is less surgical trauma, preservation of a portion of lung parenchyma, significant reduction in perioperative complications and improved quality of life for patients undergoing surgery. This advantage can be a valid argument in favor of sublobar resection for early lung cancer in patients with comorbidities as well as elderly and geriatric patients.
MATERIALS AND METHODS: A search for scientific sources was conducted using PubMed, Medline and Elibrary databases. The timeframe for the search was 2019-2025. Based on these and other criteria, 177 articles were analyzed. Of these, 67 met the inclusion criteria.

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