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Beyond the Standard: A Paradigm Shift with Precision Lung Cancer Surgery

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 30 August 2024 | Viewed by 2760

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Special Issue Editors

Prof. Dr. Kimihiro Shimizu

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Guest Editor

Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
Interests: lung cancer surgery
Special Issues, Collections and Topics in MDPI journals

Dr. Takashi Eguchi

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Guest Editor

Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
Interests: complex lung segmentectomy; lung cancer; minimally invasive surgery; perioperative risk assessment; robotic surgery; spread through air spaces (STAS)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue of the journal Cancers focuses on the paradigm shift in the field of lung cancer surgery, with a particular emphasis on “precision” surgery with the recent advances in lung-preserving sublobar resection. Recent trials have challenged the traditional approach of lobectomy for early-stage lung cancer, showing that sublobar resection can be just as effective in terms of survival rates.

The articles in this Special Issue cover a range of topics related to the shift towards precision surgery, including studies on the efficacy and safety of lung-preserving sublobar resection compared to traditional lobectomy. In addition, the Special Issue explores the latest advances in personalized and tailored treatments based on individual functional status, as well as simulation and navigation technology that can help to guide surgeons to achieve successful resections. The Special Issue also features articles on the use of localization tools in lung cancer surgery, which can help to improve the accuracy of tumor targeting.

Overall, this Special Issue showcases the exciting developments in the field of early-stage lung cancer surgery and highlights the potential for precision surgery to improve patient outcomes. With contributions from leading experts in the field, this Special Issue is a must-read for anyone interested in the latest research and advancements in lung cancer surgery.

Prof. Dr. Kimihiro Shimizu
Dr. Takashi Eguchi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

early-stage lung cancer
surgery
lung-preserving sublobar resection
localization tools
tailored treatment

Published Papers (3 papers)

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Research

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11 pages, 3450 KiB

Open AccessArticle

Comparison of the Learning Curve between Uniportal and Robotic Thoracoscopic Approaches in Pulmonary Segmentectomy during the Implementation Period Using Cumulative Sum Analysis

by Hitoshi Igai, Kazuki Numajiri, Fumi Ohsawa, Kazuhito Nii and Mitsuhiro Kamiyoshihara

Cancers 2024, 16(1), 184; https://doi.org/10.3390/cancers16010184 - 29 Dec 2023

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Abstract

Background: The aim of this retrospective study was to compare the learning curve and perioperative outcomes between the two approaches uVATS and RATS during their implementation periods. Methods: The uVATS group included 77 consecutive uVATS segmentectomies performed by HI between February 2019 and June 2022, while the RATS group included 30 between July 2022 and September 2023. The patient characteristics, perioperative outcomes, and learning curves were compared between the two groups. The learning curve was evaluated using operative time and cumulative sum (CUSUM_OT) analysis. Results: Most patient characteristics and perioperative outcomes were equivalent between the two groups. In the uVATS group, after a positive slope was observed until the 14th case (initial period), a plateau was observed until the 38th case (stable period). Finally, a negative slope was observed after the 38th case (proficiency period). In the RATS group, after a positive slope was observed until the 16th case (initial period), a plateau was observed until the 22nd case (stable period). Finally, a negative slope was observed after the 22nd case (proficiency period). Conclusions: In segmentectomy, a surgeon reached the proficiency period earlier in RATS than in uVATS, although the trends to the stable period were similar. Full article

(This article belongs to the Special Issue Beyond the Standard: A Paradigm Shift with Precision Lung Cancer Surgery)

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11 pages, 14185 KiB

Open AccessCommunication

Influencing Factors on Intersegmental Identification Adequacy in Segmentectomy with Intraoperative Indocyanine Green (ICG) Intravenous Administration

by Harushi Ueno, Tomohiro Setogawa, Ayaka Makita, Yuko Ohara, Yoshito Imamura, Shoji Okado, Hiroki Watanabe, Yuta Kawasumi, Yuka Kadomatsu, Taketo Kato, Shota Nakamura, Tetsuya Mizuno and Toyofumi Fengshi Chen-Yoshikawa

Cancers 2023, 15(24), 5876; https://doi.org/10.3390/cancers15245876 - 17 Dec 2023

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Abstract

Accurate identification of the intersegmental plane is essential in segmentectomy, and Indocyanine Green (ICG) assists in visualizing lung segments. Various factors, including patient-related, intraoperative, and technical issues, can influence boundary delineation. This study aims to assess the rate of unsuccessful intersegmental identification and identify the contributing factors. We analyzed cases of lung segmentectomy from April 2020 to March 2023, where intraoperative ICG was intravenously administered during robot-assisted or video-assisted thoracoscopic surgery. Cases where fluorescence extended beyond expected boundaries within 30 s were classified as the “unclear boundary group”. This group was then compared to the “clear boundary group”. The study encompassed 111 cases, 104 (94%) of which were classified under the “clear boundary group” and 7 (6%) under the “unclear boundary group”. The “unclear boundary group” had a significantly lower DLCO (15.7 vs. 11.8, p = 0.03) and DLCO/VA (4.3 vs. 3.0, p = 0.01) compared to the “clear boundary group”. All cases in the “unclear boundary group” underwent lower lobe segmentectomy. ICG administration effectively outlines pulmonary segments. Challenges in segment demarcation may occur in cases with low DLCO and DLCO/VA values, particularly during lower lobe segmentectomy. Full article

(This article belongs to the Special Issue Beyond the Standard: A Paradigm Shift with Precision Lung Cancer Surgery)

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Graphical abstract

Review

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12 pages, 3213 KiB

Open AccessReview

Harnessing 3D-CT Simulation and Planning for Enhanced Precision Surgery: A Review of Applications and Advancements in Lung Cancer Treatment

by Kazutoshi Hamanaka, Kentaro Miura, Takashi Eguchi and Kimihiro Shimizu

Cancers 2023, 15(22), 5400; https://doi.org/10.3390/cancers15225400 - 14 Nov 2023

Viewed by 972

Abstract

The clinical application of three-dimensional computed tomography (3D-CT) technology has rapidly expanded in the last decade and has been applied to lung cancer surgery. Two consecutive reports of large-scale prospective clinical trials from Japan and the United States have brought a paradigm shift in lung cancer surgery and may have led to a rapid increase in sublobar lung resections. Sublobar resection, especially segmentectomy, requires a more precise understanding of the anatomy than lobectomy, and preoperative 3D simulation and intraoperative navigation support it. The latest 3D simulation software packages are user-friendly. Therefore, in this narrative review, we focus on recent attempts to apply 3D imaging technologies, particularly in the sublobar resection of the lung, and review respective research and outcomes. Improvements in CT accuracy and the use of 3D technology have advanced lung segmental anatomy. Clinical applications have enabled the safe execution of complex sublobar resection through a minimally invasive approach, such as video-assisted thoracoscopic surgery and robotic surgery. However, currently, many facilities still render 3D images on two-dimensional monitors for usage. In the future, it will be challenging to further spread and advance intraoperative navigation through the application of 3D output technologies such as extended reality. Full article

(This article belongs to the Special Issue Beyond the Standard: A Paradigm Shift with Precision Lung Cancer Surgery)

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