YOUNG-JEN LINXU-HENG CHIANGTZU-PIN LUMIN-SHU HSIEHHSAO-HSUN HSUMONG-WEI LINJIN-SHING CHEN2022-05-032022-05-0320222234-943Xhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85124188476&doi=10.3389%2ffonc.2021.777590&partnerID=40&md5=e2a4f0ae966a8637e281d5d1f53d8e6fhttps://scholars.lib.ntu.edu.tw/handle/123456789/609361Objectives: The choice of resection method for geriatric patients with early-stage non-small cell lung cancer (NSCLC) remains contentious. This study aimed to evaluate survival and perioperative outcomes after thoracoscopic lobectomy resection (LR) or sublobar resection (SR) in patients aged ≥75 years with pathologic stage (pStage) I NSCLC. Materials and methods: We retrospectively examined 258 consecutive patients aged ≥75 years with pStage I NSCLC who underwent thoracoscopic tumor resection at our institute from 2011 to 2018. Propensity score matching (PSM) analysis identified 60 patients in each group for comparison of survival-related parameters, including disease-free survival (DFS), lung cancer-specific overall survival (OS), and non-lung cancer-specific OS, using the Kaplan-Meier analysis. Results: LR and SR were performed in 84 (32.6%) and 174 (67.4%) patients aged ≥75 years, respectively. The LR group had younger patients, better performance status, larger tumor sizes, and deeper tumor location than the SR group. Multivariate studies showed that the resection method was not a prognostic factor for OS. The two PSM-matched groups were not significantly different with respect to lung cancer-specific OS (p = 0.116), non-lung cancer-specific OS (p = 0.408), and DFS (p = 0.597). SR helped achieve better perioperative outcomes than LR, including fewer postoperative complications (10.0% vs. 28.3%, p = 0.011), shorter operative times (p < 0.001), decreased blood loss (p = 0.026), and shorter chest tube duration (p = 0.010) and hospital stays (p = 0.035). Conclusions: Thoracoscopic SR may provide similar oncological outcomes to LR, but may be a safer and more feasible surgical method for geriatric patients with pStage I NSCLC.endisease-free survivalearly-stage non-small cell lung cancerlobectomy resectionoverall survivalsublobar resectionthoracoscopic[SDGs]SDG3journal article10.3389/fonc.2021.7775902-s2.0-85124188476