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Cancers
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Advances in Surgical Treatment of Early-Stage Non-small Cell Lung Cancer
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Advances in Surgical 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: closed (30 December 2023) | Viewed by 3091

Special Issue Editor

Dr. Robert E. Merritt

E-Mail Website
Guest Editor
Department of Surgery, Ohio State University - Wexner Medical Center, Columbus, OH, USA
Interests: pulmonary segmentectomy; robotic assisted pulmonary resection; immunotherapy

Special Issue Information

Dear Colleagues,

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. It is typically treated with a combination of surgery, chemotherapy, and radiation therapy. In recent years, immune checkpoint inhibitor therapy has emerged as an effective treatment of NSCLC. Surgical techniques used to treat NSCLC include lobectomy, segmentectomy, and wedge resection. These techniques involve the removal of part or all of the affected lung tissue. Additionally, newer techniques such as robotic surgery and minimally invasive surgery are being used to improve outcomes and reduce recovery time.

This Special Issue focuses on the most recent advancements in the surgical treatment of early-stage non-small cell lung cancer. It will include reviews of the latest clinical trials and research, as well as perspectives from leading experts in the field. We hope that it can provide a platform for further research and development in this field.

Dr. Robert E. Merritt
Guest Editor

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 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

  • non-small cell lung cancer
  • surgery
  • therapy
  • chemotherapy
  • immune checkpoint inhibitor therapy

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (2 papers)

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Research

9 pages, 3563 KiB  
Article
Simultaneous Visualization of Lung Tumor and Intersegmental Plane during Pulmonary Segmentectomy by Intravenous Injection of Indocyanine Green
by Kyungsu Kim, Ok Hwa Jeon, Byeong Hyeon Choi, Jiyun Rho, Jun Hee Lee, Jae Seon Eo, Beop-Min Kim and Hyun Koo Kim
Cancers 2024, 16(7), 1439; https://doi.org/10.3390/cancers16071439 - 8 Apr 2024
Viewed by 1360
Abstract
Segmentectomy is a targeted surgical approach tailored for patients with compromised health and early-stage lung cancer. The key to successful segmentectomy lies in precisely identifying the tumor and intersegmental planes to ensure adequate resection margins. In this study, we aimed to enhance this [...] Read more.
Segmentectomy is a targeted surgical approach tailored for patients with compromised health and early-stage lung cancer. The key to successful segmentectomy lies in precisely identifying the tumor and intersegmental planes to ensure adequate resection margins. In this study, we aimed to enhance this process by simultaneously visualizing the tumor and intersegmental planes through the intravenous injection of indocyanine green (ICG) at different time points and doses. Lung tumors were detected by intravenous injection of ICG at a dose of 2 mg/kg 12 h before surgery in a rabbit model. Following the dissection of the pulmonary artery, vein, and bronchi of the target segment, 0.6 mg/kg of ICG was injected intravenously to detect the intersegmental plan. Fluorescent images of the lung tumors and segments were acquired, and the fluorescent signal was quantified using the signal-to-background ratio (SBR). Finally, a pilot study of this method was conducted in three patients with lung cancer. In a preclinical study, the SBR of the tumor (4.4 ± 0.1) and nontargeted segments (10.5 ± 0.8) were significantly higher than that of the targeted segment (1.6 ± 0.2) (targeted segment vs. nontarget segment, p < 0.0001; target segment vs. tumor, p < 0.01). Consistent with preclinical results, lung tumors and the intersegmental plane were successfully detected in patients with lung cancer. Consequently, adequate resection margins were identified during the surgery, and segmentectomy was successfully performed in patients with lung cancer. This study is the first to use intravenous ICG injections at different time points and doses to simultaneously detect lung cancer and intersegmental planes, thereby achieving segmentectomy for lung cancer. Full article
(This article belongs to the Special Issue Advances in Surgical Treatment of Early-Stage Non-small Cell Lung Cancer)
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14 pages, 6742 KiB  
Article
Sarcopenia and Mediastinal Adipose Tissue as a Prognostic Marker for Short- and Long-Term Outcomes after Primary Surgical Treatment for Lung Cancer
by Florian Ponholzer, Georg Groemer, Caecilia Ng, Herbert Maier, Paolo Lucciarini, Florian Kocher, Dietmar Öfner, Eva Gassner, Stefan Schneeberger and Florian Augustin
Cancers 2023, 15(23), 5666; https://doi.org/10.3390/cancers15235666 - 30 Nov 2023
Cited by 2 | Viewed by 1382
Abstract
Surgical resection remains the gold standard of treatment for early-stage lung cancer. Several risk models exist to predict postoperative morbidity and mortality. Psoas muscle sarcopenia has already successfully been used for morbidity prediction in lung transplantation and is not yet included in the [...] Read more.
Surgical resection remains the gold standard of treatment for early-stage lung cancer. Several risk models exist to predict postoperative morbidity and mortality. Psoas muscle sarcopenia has already successfully been used for morbidity prediction in lung transplantation and is not yet included in the available risk scores for pulmonary resections. We hypothesized that the skeletal muscle index and mediastinal adipose tissue might also have an impact on postoperative outcomes after primary surgery for primary lung cancer. The institutional database was queried for patients with primary lung cancer who were treated with primary lobectomy or segmentectomy between February 2009 and November 2018. In total, 311 patients were included for analysis. Patients receiving neo-/adjuvant chemotherapy or with a positive nodal status were excluded to rule out any morbidity or mortality due to (neo-)adjuvant treatment. Sarcopenia was defined as a skeletal muscle index of <34.4 cm2/m2 for women and <45.4 cm2/m2 for men. Mediastinal adipose tissue was defined with a radiodensity of −150 to −30 Hounsfield units. Sarcopenia was diagnosed in 78 (25.1%) of the 311 patients. Male patients were significantly more likely to suffer from sarcopenia (31.5% vs. 18.1%, p = 0.009). Comorbidities, lung function, tumour histology, pathologic tumour staging, mediastinal adipose tissue and age did not differ between groups with or without sarcopenia. Sarcopenic patients had a significantly longer length of stay, with 13.0 days vs. 9.5 (p = 0.003), and a higher rate of any postoperative complications (59.0% vs. 44.6%, p = 0.036). There was no difference in recurrence rate. Five-year overall survival was significantly better in the patient cohort without sarcopenia (75.6% vs. 64.5%, p = 0.044). Mediastinal adipose tissue showed no significant impact on length of stay, postoperative complications, recurrence rate, morbidity or survival. Sarcopenia, quantified with the skeletal muscle index, is shown to be a risk factor for postoperative morbidity and reduced survival in primary lung cancer. Efforts should be taken to pre-emptively screen for sarcopenia and start countermeasures (e.g., physical prehabilitation, protein-rich nutrition, etc.) during the preoperative workup phase. Full article
(This article belongs to the Special Issue Advances in Surgical Treatment of Early-Stage Non-small Cell Lung Cancer)
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