Pascal-Alexandre Thomas

Highlights • Despite a more stringent selection process, the number of octogenarians with an early-stage NSCLC almost doubled each 5-year interval of the study period. • The implementation of a dedicated geriatric pathway for patients ‘evaluation and the use of minimally invasive approaches in the frame of an Enhanced Recovery After Surgery program were both associated with a significantly decreased rate of major postoperative complications, and improved overall survival.

Analyses of large contemporaneous national databases, even in the era of modern pre-treatment staging methods, show a 10–20% incidence of nodal upstaging in patients with clinical stage I non-small-cell lung cancer (NSCLC) and treated with lobectomy. Therefore, lymphadenectomy is still heralded as a hallmark of surgical quality. However, this opinion is often poorly adhered to in clinical practice.