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Lung Cancer: Major Pulmonary Resections and Lymph Node Dissection in the Era of Evolving Therapies

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

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 1013

Special Issue Editor


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Guest Editor
Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
Interests: lung cancer; thoracic surgery; mediastinum; advanced lung cancers; NETs
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Major pulmonary resections such as bilobectomy and pneumonectomy remain essential procedures for the treatment of locally advanced non-small cell lung cancer (NSCLC), particularly when parenchyma-sparing surgery is not feasible. Despite their decreasing frequency, these surgeries are associated with high postoperative morbidity and mortality, making the optimization of perioperative management a critical area of interest. This Special Issue aims to provide an up-to-date overview of the surgical and clinical management of major lung resections, with a specific focus on aspects such as drainage strategies, fluid balance, respiratory support, and postoperative complications. In addition, we seek to explore how the advent of targeted therapies and immune checkpoint inhibitors is reshaping the indications and outcomes of extensive lung resections. Contributions may include original research, reviews, and clinical perspectives on integrating systemic therapies with surgical strategies to improve oncologic results and patient quality of life. This issue offers a platform for thoracic surgeons, oncologists, and multidisciplinary teams to share insights into best practices and future directions in the management of complex NSCLC cases.

Dr. Giuseppe Marulli
Guest Editor

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Keywords

  • non-small cell lung cancer (NSCLC)
  • pneumonectomy
  • bilobectomy
  • perioperative management
  • postoperative drainage
  • complications of major lung resections
  • immune checkpoint inhibitors
  • targeted therapies
  • surgical oncology
  • thoracic surgery

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Published Papers (1 paper)

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Research

12 pages, 839 KB  
Article
Predictors of Recurrence After Surgery in Patients with Stage I Non-Small Cell Lung Cancer
by Emanuele Voulaz, Debora Brascia, Veronica Giudici, Stefano Margaritora, Marco Lucchi, Vittorio Aprile, Marco Chiappetta, Alexandro Patirelis, Vincenzo Ambrogi and Giuseppe Marulli
Cancers 2026, 18(7), 1152; https://doi.org/10.3390/cancers18071152 - 3 Apr 2026
Viewed by 748
Abstract
Background: Surgery represents the gold standard treatment for patients with stage I non-small cell lung cancer (NSCLC); however, up to 30% of those may experience recurrence. This study aims to identify prognostic factors for both early and late recurrence in this subset. Methods: [...] Read more.
Background: Surgery represents the gold standard treatment for patients with stage I non-small cell lung cancer (NSCLC); however, up to 30% of those may experience recurrence. This study aims to identify prognostic factors for both early and late recurrence in this subset. Methods: We retrospectively analyzed the data of patients with stage IA-B NSCLC undergoing lung resection from 2013 to 2021 in four major lung cancer centers. Inclusion criteria were intentionally curative resections via either open or mini-invasive approaches plus lymph node dissection and a minimum follow-up of 36 months. Analyzed prognosticators included age, gender, smoking status, comorbidities, radiological appearance, surgical approach, intraoperative complications, pT stage and histologic subtypes. The overall and disease-free survivals and uni- and multivariable Cox regression for recurrence prediction were analyzed. Results: We collected data from 1132 consecutive patients (mean age 68.5 ± 8.8 years, 55.5% males and 20.1% smokers). After a mean follow-up of 57 ± 37 months, 908 (80.2%), patients were still disease-free, while the remaining 224 (19.8%) presented local (n = 86) or distant (n = 138) recurrences; 72 (32.1%) patients experienced reoccurrence within 12 months. The disease-free survival rate was significantly higher in the pT1a stage and in lepidic adenocarcinoma. The multivariable analysis and Cox regression showed that pT>1a (p = 0.001) and non-lepidic subtypes of adenocarcinoma (p < 0.001) were the best predictors of recurrence. Conclusions: Approximately one fifth of patients undergoing radical surgery for stage I NSCLC experienced recurrence within five years. Significant predictors of recurrence were a pT status greater than 1a and non-lepidic subtypes of adenocarcinoma. Full article
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