A New Era in Treatment of Early-Stage Non-Small Cell Lung Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 25 February 2025 | Viewed by 3784

Special Issue Editor


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Guest Editor
Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osakasayama 589-8511, Japan
Interests: segmentectomy for NSCLC; perioperative systemic therapy for NSCLC; clinical trials of lung cancer surgery

Special Issue Information

Dear Colleagues,

The standard of care for early-stage non-small cell lung cancer (NSCLC) has changed dramatically with increasing evidence for minimally invasive surgery, such as video-assisted thoracic surgery (VATS) and robotic-assisted thoracic surgery (RATS); sublobar resection, such as segmentectomy or wedge resection; and perioperative immunotherapy or targeted therapy.

We are pleased to invite you to submit your experimental and theoretical results regarding new treatments for early-stage NSCLC. Full experimental details must be provided so that the results can be reproduced.

This Special Issue aims to encourage scientists to publish their own institutional experiences and scientific results regarding the new normal for the treatment of early-stage NSCLC, which includes minimally invasive surgery, sublobar resection, or perioperative therapy, and to understand and apply the development of this new era of early-stage NSCLC treatment in their daily clinical practice.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Minimally invasive surgery for lung cancer.
  • Sublobar resection for early-stage NSCLC.
  • Perioperative therapy for early-stage NSCLC.

I look forward to receiving your contributions.

Prof. Dr. Tsutani Yasuhiro
Guest Editor

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Keywords

  • minimally invasive surgery
  • video-assisted thoracic surgery
  • robotic-assisted thoracic surgery
  • sublobar resection
  • segmentectomy
  • neoadjuvant therapy
  • adjuvant therapy
  • immunotherapy
  • targeted therapy

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Published Papers (3 papers)

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Research

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9 pages, 3080 KiB  
Article
Pathologic Response and Survival after Neoadjuvant Chemotherapy with Bevacizumab Followed by Surgery for Clinical Stage II/IIIA Nonsquamous Non-Small-Cell Lung Cancer: Results from a Phase II Feasibility Study (NAVAL)
by Yasuhiro Tsutani, Yoshihiro Miyata, Kenji Suzuki, Fumihiro Tanaka, Hiroyuki Ito, Yoshinori Yamashita and Morihito Okada
Cancers 2024, 16(13), 2363; https://doi.org/10.3390/cancers16132363 - 27 Jun 2024
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Abstract
The objective of this study was to evaluate the relationship between pathologic response and survival in patients with clinical stage II/IIIA nonsquamous non-small-cell lung cancer (NSCLC) who intended to undergo neoadjuvant chemotherapy with bevacizumab, followed by surgery. In this phase II NAVAL study [...] Read more.
The objective of this study was to evaluate the relationship between pathologic response and survival in patients with clinical stage II/IIIA nonsquamous non-small-cell lung cancer (NSCLC) who intended to undergo neoadjuvant chemotherapy with bevacizumab, followed by surgery. In this phase II NAVAL study evaluating the feasibility of neoadjuvant chemotherapy with cisplatin (75 mg/m2), pemetrexed (500 mg/m2), and bevacizumab (15 mg/kg), followed by surgery, progression-free survival (PFS) and overall survival (OS) were assessed as the secondary endpoints. Patients were categorized based on the proportion of residual viable primary tumor in the resected specimen after neoadjuvant chemotherapy: those with residual tumor in less than one-third were classified as pathologic responders, the rest as nonresponders. Of the 30 patients, 25 underwent surgical resection after three cycles of neoadjuvant chemotherapy with bevacizumab; 5 did not undergo surgery. Among all 30 patients, the rates of 2- and 5-year PFS were 41.5% and 34.6%, respectively, and the rates of 2- and 5-year OS were 70.0% and 60.0%, respectively. A total of 6 patients (20%) were classified as pathologic responders; the other 24 (80%), as nonresponders. The five-year PFS differed significantly between pathologic responders (100%) and nonresponders (17.5%; p = 0.002). The five-year OS also differed significantly between pathologic responders (100%) and nonresponders (43.5%; p = 0.006). Pathologic response seems to be a predictor of survival. Long-term survival after surgery is expected for pathologic responders, whereas additional therapy is needed for nonresponders. Full article
(This article belongs to the Special Issue A New Era in Treatment of Early-Stage Non-Small Cell Lung Cancer)
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11 pages, 1898 KiB  
Article
The Clinical Role of Adjuvant Chemotherapy after Sublobar Resection for Non-Small-Cell Lung Cancer ≤ 20 mm with Lymph Node Metastases: A Propensity-Matched Analysis of the National Cancer Database
by Shinkichi Takamori, Junjia Zhu, Asato Hashinokuchi and Takefumi Komiya
Cancers 2024, 16(12), 2176; https://doi.org/10.3390/cancers16122176 - 8 Jun 2024
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Abstract
Sublobar resection is a standard surgical procedure for small-sized non-small-cell lung cancer (NSCLC). However, the clinical role of adjuvant chemotherapy for small-sized NSCLC with pathological lymph node (LN) metastasis after sublobar resection is unknown. The National Cancer Database was queried for NSCLC patients [...] Read more.
Sublobar resection is a standard surgical procedure for small-sized non-small-cell lung cancer (NSCLC). However, the clinical role of adjuvant chemotherapy for small-sized NSCLC with pathological lymph node (LN) metastasis after sublobar resection is unknown. The National Cancer Database was queried for NSCLC patients between 2004 and 2018. Eligibility included sublobar resection with pathological LN metastasis, R0 resection, Charlson comorbidity score = 0, clinical stage T1a-b, and tumor size ≤ 20 mm. The Kaplan–Meier method with a log-rank test and multivariable Cox proportional hazards analyses were used for assessing survival. The samples were evaluated before and after propensity score matching (PSM) with respect to age, sex, histologic type, and pathological LN status. Of 810 patients who met the eligibility criteria, 567 (70.0%) underwent adjuvant chemotherapy. After PSM, patients with adjuvant chemotherapy had a significantly longer survival than those without (median survival: 64.3 vs. 34.0 months, hazard ratio for death: 0.61, p < 0.0001). Multivariate analyses after PSM showed that younger age (p = 0.0206), female (p = 0.0005), and adjuvant chemotherapy (p < 0.0001) were independent prognostic factors for longer survival. Adjuvant chemotherapy has a prognostic impact in patients with small-sized NSCLC and pathological lymph node metastasis who undergo sublobar resection. Full article
(This article belongs to the Special Issue A New Era in Treatment of Early-Stage Non-Small Cell Lung Cancer)
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Review

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17 pages, 13327 KiB  
Review
Uniportal Video-Assisted Thoracoscopic Segmentectomy for Early-Stage Non-Small Cell Lung Cancer: Overview, Indications, and Techniques
by Takuya Watanabe, Masayuki Tanahashi, Eriko Suzuki, Naoko Yoshii, Takuya Kohama, Kensuke Iguchi and Takumi Endo
Cancers 2024, 16(13), 2343; https://doi.org/10.3390/cancers16132343 - 26 Jun 2024
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Abstract
Twenty years have passed since uniportal video-assisted thoracoscopic surgery (VATS) was first reported. Several reports have already proven the minimal invasiveness of uniportal VATS. In addition, two large clinical trials recently demonstrated the benefits of segmentectomy for small peripheral early-stage non-small cell lung [...] Read more.
Twenty years have passed since uniportal video-assisted thoracoscopic surgery (VATS) was first reported. Several reports have already proven the minimal invasiveness of uniportal VATS. In addition, two large clinical trials recently demonstrated the benefits of segmentectomy for small peripheral early-stage non-small cell lung cancer. Uniportal VATS segmentectomy is considered the most beneficial minimally invasive surgery for patients with early-stage lung cancer. However, a high level of skill and experience are required to achieve this goal. Only a few reports have discussed specific techniques, particularly for complex segmentectomies. In this Special Issue, we reviewed previous reports on uniportal VATS segmentectomy regarding the indications, instrument selection, marking of the tumor location, methods of intersegmental plane identification, and lymph node dissection, including our own techniques with video content. Full article
(This article belongs to the Special Issue A New Era in Treatment of Early-Stage Non-Small Cell Lung Cancer)
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