This multicenter prospective clinical study focuses on elderly patients with lung cancer. The investigators will build a standardized clinical registry database, develop perioperative risk stratification and surgical early-warning models, optimize individualized surgical regimens, construct multidisciplinary perioperative comprehensive therapy, integrated Chinese-Western medicine full-cycle management and personalized postoperative rehabilitation systems, so as to form a whole-process optimized treatment model for elderly lung cancer.
Aged ≥65 years old
Pathologically confirmed non-small cell lung cancer with clinical stage eligible for curative surgical resection
Complete preoperative geriatric comprehensive assessment data available
Capable of finishing planned surgery and long-term follow-up
History of other malignant tumors within recent 5 years
Severe organic dysfunction of heart, liver, renal or respiratory system that cannot tolerate thoracic surgery
Preoperative confirmed distant metastasis preventing radical resection
Uncontrolled active severe infection or obvious coagulation disorders
Parallel
Pulmonary Lobectomy plus Mediastinal Lymph Node Sampling
Procedure/SurgeryStandard anatomical lobectomy combined with systematic mediastinal lymph node sampling for early-stage T1N0M0 non-small cell lung cancer in patients aged ≥65 years; postoperative stratified adaptive perioperative management guided by MRD and tumor biomarkers.
Pulmonary Segmentectomy plus Mediastinal Lymph Node Sampling
Procedure/SurgeryCurative segmentectomy with mediastinal lymph node sampling after preoperative comprehensive geriatric risk assessment (CGA, VES-13, ASA grading); postoperative personalized perioperative treatment stratified by postoperative minimal residual disease status.
Pulmonary Wedge Resection plus Mediastinal Lymph Node Sampling
Procedure/SurgeryWedge resection plus mediastinal lymph node sampling for eligible elderly early lung cancer patients; low-risk subjects receive de-escalated adaptive perioperative treatment, while high-risk patients receive intensified comprehensive therapy based on postoperative risk stratification.
Overall Survival (OS)
The time from randomization to all-cause death, to compare long-term survival difference among lobectomy, segmentectomy and wedge resection groups in elderly early-stage lung cancer patients.
Postoperative Major Complications Rate
Incidence of grade ≥3 postoperative adverse complications within 90 days after surgery, comparing surgical safety across three resection strategies.
Disease-Free Survival (DFS)
Time from randomization to tumor recurrence or death; explore recurrence difference guided by postoperative MRD-based adaptive perioperative treatment.
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