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Recent Advances in Trachea, Bronchus and Lung Cancer Management: 2nd Edition

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Dear Colleagues,

According to the WHO, trachea, bronchus and lung cancer deaths rose to 1.8 million worldwide in 2019, remaining the leading cause of death from malignancies and the sixth most common cause of death overall. However, for upper-middle- and high-income countries, these occupied the fourth place.

Nevertheless, significant breakthroughs are made every year in their management.

The purpose of this Special Issue is to consolidate the most recent advances in trachea, bronchus and lung cancer management, from the moment of clinical suspicion to diagnosis and treatment options, aiming to provide a comprehensive and up-to-date tool which will assist clinicians in combatting this lethal disease.

This is the 2nd edition of the Special Issue that welcomes research articles and review papers on trachea, bronchus and lung cancer management. We encourage you to read the publications in the first edition at https://www.mdpi.com/journal/cancers/special_issues/6KY804G5B2.

Dr. Serafeim Chrysovalantis Kotoulas
Dr. Dionisios G. Spyratos
Dr. Athanasia Pataka
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12 pages, 1033 KB

Open AccessArticle

Tumor Size in Early-Stage NSCLC Is a Prognostic Factor in Single Segmentectomies but Not in Multiple Segmentectomies: A Single-Center Analysis

by Marco Chiappetta, Antonio Giulio Napolitano, Carolina Sassorossi, Dania Nachira, Filippo Lococo, Elisa Meacci, Chiara Scognamiglio, Maria Teresa Congedo, Gloria Santoro, Ettore D’Argento, Jacopo Russo, Guido Horn and Stefano Margaritora

Cancers 2025, 17(17), 2778; https://doi.org/10.3390/cancers17172778 - 26 Aug 2025

Viewed by 249

Abstract

Objective: Segmentectomy has recently been accepted as a valid anatomical resection in the early stages non-small cell lung cancer, even if different segment numbers and combinations are included. The aim of this study is to analyze prognostic factors in patients who underwent segmentectomy, with particular attention to segment numbers and characteristics. Methods: Characteristics of patients who underwent uniportal VATS segmentectomy from 1/01/2017 to 31/12/2022 were reviewed and retrospectively analyzed. Patients with nodal involvement and/or distant metastases, tumors > 4 cm, who received neoadjuvant treatment and those who underwent completion lobectomy were excluded. Operatory and pathological reports were reviewed to collect data on surgical characteristics and pathology. Segmentectomies were categorized according to numbers of resected segments as single/multiple. Clinico-pathological characteristics, number of segments and nodal parameters were associated to overall survival (OS) using Kaplan–Meier curves. The log-rank test was used to assess differences between subgroups. A multivariable model was built using Cox-regression analysis including variables with p-values < 0.10 at univariable analysis. Results: The final analysis was conducted on 95 patients who met the inclusion criteria. Multiple segmentectomies were performed in 47 (49.4%) cases, of which 37 (39%) were complex cases. At univariable analysis, tumor size ≤ 2 cm (p = 0.006, HR:0.260; 95%CI 0.099–0.686) significantly correlated with OS: patients with pT ≤ 2 cm presented a 5YOS of 85.3% vs. 48.3% of patients with pT >2 cm, with multivariable-confirmed tumor size ≤ 2 cm as an independent prognostic factor (p = 0.004, HR:0.204; 95%CI 0.069–0.607). Considering the tumor size according to number of resected segments, patients who underwent single segmentectomy presented a significantly better survival for pT ≤ 2 cm: 5YOS 91.7% vs. 41.3% for pT > 2 cm (p = 0.001). Conversely, no significant differences in OS were present in multiple segmentectomy: 5YOS 78.9% vs. 77.1% (p = 0.700). Similarly, pT ≤ 2 cm correlated with OS in complex segmentectomy (p = 0.010) but not in simple segmentectomy (p = 0.098). Conclusions: Our study confirms the distinct prognosis associated with tumor dimensions in patients who underwent uniportal VATS segmentectomy. We confirmed the tumor dimension cut-off of 2 cm as a robust prognosticator in single and complex segmentectomies. However, no significant differences in survival were observed in multiple and simple segmentectomies, implying that tumors larger than 2 cm may necessitate extended resections. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management: 2nd Edition)

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