Outcomes of video-assisted thoracoscopic lobectomy with lymph node dissection for early-stage non-small cell lung cancer at Hanoi Medical University Hospital

Background: Video-assisted thoracoscopic lobectomy with systematic lymph node dissection has become a standard surgical treatment for early-stage non-small cell lung cancer. This study aimed to describe the clinical, paraclinical and pathological staging characteristics and to evaluate the surgical outcomes of this technique. Methods: A retrospective descriptive study was conducted on 80 patients who underwent thoracoscopic lobectomy with lymph node dissection at Hanoi Medical University Hospital from September 2021 to December 2024. Survival was analysed using the Kaplan-Meier method and the log-rank test. Results: The mean age was 61.3 ± 8.6 years and 53.8% of patients were male. Non-mucinous adenocarcinoma accounted for 85.0%, invasive mucinous adenocarcinoma for 5.0% and squamous cell carcinoma for 5.0%. There were 1, 55, 10 and 14 patients in stages 0, I, II and IIIA. Early complications occurred in 35.0% of patients, mostly Clavien-Dindo grade I–II, with prolonged air leak being the most common (17.5%); 30-day mortality was 1.3%. The three-year overall survival and disease-free survival rates were 86.2% and 62.6%, respectively. High-grade adenocarcinoma had significantly lower disease-free survival than grade 1–2 tumours (34.1% versus 69.8%; p = 0.023). Conclusions: Thoracoscopic lobectomy with lymph node dissection for early-stage non-small cell lung cancer is safe, with low rates of severe complications and mortality and favourable mid-term survival. The histologic grade is a notable prognostic factor for disease-free survival.