Lung Cancer Outcomes in Vietnam: A 6-Year Retrospective Study.

Introduction: This study aims to document patient characteristics, treatment modalities, and survival outcomes of patients with lung cancer in Vietnam from 2018 to 2024. Methods: This was a retrospective study of patients with lung cancer treated at Nghe An Oncology Hospital over a 6-year period (2018-2024). The primary endpoints included lung cancer treatment methods for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) and overall survival (OS). Secondary endpoints involved factors related to survival duration. Results: A total of 3548 patients were included: 3087 with NSCLC (87%) and 419 with SCLC (11.8%) (median age 64 years, range 18-97 years; 3:1 male-to-female ratio). Adenocarcinoma (AC) was the predominant histologic subtype (67%), followed by squamous cell carcinoma (SCC) (13.4%). EGFR mutation was detected in 43.2% of cases. From 2018 to 2024, the proportion of early-stage lung cancer diagnoses (stages I and II) increased from 2.7% to 9%, and the detection rate of advanced or metastatic stages (stages III and IV) decreased. Surgery was the primary treatment for localized NSCLC (62.5%), and stage III cases predominantly received radiation and chemotherapy (40.8%), including 38.6% with concurrent chemoradiotherapy. In stage IV NSCLC, chemotherapy was the most common treatment (53.9%), followed by targeted therapy (25.2%) and immunotherapy (1.9%). SCLC was mostly diagnosed at the extensive stage (68.0%), with chemotherapy being the mainstay of treatment (73.0%), followed by chemoradiotherapy (12.9%) and palliative care (13.1%). Median OS was 15.3 months (95% CI, 14.5-16.1), with a 5-year survival rate of 14.2%. Median OS for NSCLC cases was 16.4 months (95% CI, 15.4-17.4), with 5-year survival rates of 55.2%, 47.6%, 20.2%, and 8.3% for stages I, II, III, and IV, respectively. Median OS for SCLC cases was 11.0 months (95% CI, 9.7-12.4), with a 5-year survival rate of 4.7%. Independent prognostic factors for mortality included male sex, poor performance status (PS ≥ 2), small cell histology, metastatic disease, brain metastases, and initial nonsurgical treatment. Conclusion: This study provides critical data on the epidemiology and prognosis of lung cancer in Vietnam, highlighting the role of personalized treatment approaches in improving clinical outcomes. These findings underscore the urgent need for integrated public health strategies to enhance early detection and access to advanced therapies, thereby reducing the lung cancer burden in Vietnam.