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Vietnamese expert consensus on the diagnosis and multidisciplinary management of resectable non-small cell lung
Que Kim Do1,2, Dung Xuan Pham3, Hoa Thi Thai Nguyen4
1Thoracic and Cardiovascular Surgery Department, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
Background:
The management of resectable non-small cell lung cancer (NSCLC) has evolved rapidly from a surgery-centered approach toward biomarker-informed, multimodality care integrating staging, pathology, surgery, perioperative systemic treatment, and postoperative surveillance. In Vietnam, implementation remains heterogeneous across institutions, particularly in access to fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), invasive mediastinal staging, molecular testing, perioperative therapy, pathology standardization, and multidisciplinary review. This project aimed to develop a Vietnamese multidisciplinary expert consensus to contextualize contemporary international evidence for clinical practice in Vietnam.
Methods:
A structured, modified Delphi-informed consensus process was conducted in Vietnam between August 2025 and January 2026. The workflow comprised seven stages: scoping; a baseline practice survey; initial draft development; expert review of parts 1 and 2; post-meeting written feedback, revision, electronic recirculation, and formal voting for these sections; a multidisciplinary consensus meeting and formal voting for parts 3 and 4; and editorial harmonization and consolidation. The panel included specialists in thoracic surgery, medical oncology, respiratory medicine, pathology, nuclear medicine, radiation oncology, and related disciplines. Classes of recommendation were adapted from the European Society of Cardiology framework. All statements submitted to formal consensus voting were formally rated, with consensus predefined as at least 75% agreement.
Results:
The final document comprised 35 consensus statements across four domains: preoperative diagnosis and staging (n=7), surgery and postoperative surveillance (n=8), neoadjuvant and perioperative treatment (n=12), and adjuvant treatment (n=8). Across the meeting rosters, 32 unique experts were identified, with strong representation from thoracic surgery and medical oncology. The baseline survey and expert discussions highlighted implementation gaps in FDG-PET/CT, invasive mediastinal staging, biomarker testing, perioperative therapy, pathology standardization, and multidisciplinary review. All 35 consensus statements met the predefined threshold, with agreement ranging from 82% to 100%.
Conclusions:
These consensus statements provide a multidisciplinary, evidence-informed framework for the diagnosis and management of resectable NSCLC across the perioperative pathway. By contextualizing international evidence within Vietnamese clinical practice, the document may help improve consistency of care, support biomarker-guided and multimodality treatment, and strengthen multidisciplinary decision-making across institutions.