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Cancers
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Modern Surgical Treatments for Thoracic Malignancies
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Modern Surgical Treatments for Thoracic Malignancies

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

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 2976

Special Issue Editor

Prof. Dr. Pier Luigi Filosso

E-Mail Website
Guest Editor
Division of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
Interests: thoracic surgery; thoracic oncology; VATS; RATS
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is with great pleasure that I have accepted the invitation from Cancers to be the Editor of this Special Issue about the modern surgical treatment of thoracic malignancies. The approach to thoracic tumors has undergone major changes in recent decades, and clinical practice has adjusted accordingly: the dramatic development of minimally invasive techniques and the advances in biomolecular and chemico-pharmacological investigations have led to personalized cancer medicine. The role of the Thoracic Surgeon has therefore changed and the inter-relationships with Oncologists and Radiotherapists in common clinical practice are nowadays increasingly closer. Modern combination studies between chemotherapy, immunotherapy, and biological agents have dramatically re-defined the prognosis of patients with thoracic neoplasms. The surgical techniques required modifications, by adapting to greater technical complexities related to tissue changes as the result of oncological treatments.

This Special Issue of Cancers therefore aims to reiterate this new trend of modern Thoracic Surgery, reaffirming the concept that the treatment of thoracic neoplasms still passes through their radical resection.

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

  • Robotic surgery for lung cancer, thymoma, and mesothelioma.
  • Salvage surgery for lung cancer, thymoma, and mesothelioma.
  • Hyperthermic intrathoracic chemotherapy for lung cancer, thymoma, and mesothelioma.

I look forward to receiving your contributions.

Prof. Dr. Pier Luigi Filosso
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

  • lung cancer
  • thymoma
  • thymic carcinoma
  • mesothelioma
  • thoracic surgery
  • minimally invasive techniques
  • VATS
  • robotic surgery
  • salvage surgery
  • hyperthermic intrathoracic chemotherapy

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

Published Papers (2 papers)

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Research

15 pages, 1293 KiB  
Article
Distribution of EGFR and KRAS Mutations in Patients with Surgically Resected Non-Small Cell Lung Cancer from Southern Italy: Real-Life Data from a Single Institution and Literature Review
by Michele Piazzolla, Paola Parente, Flavia Centra, Federico Pio Fabrizio, Marco Donatello Delcuratolo, Antonella Centonza, Concetta Martina Di Micco, Mario Mastroianno, Francesco Delli Muti, Fabiola Fiordelisi, Gianmaria Ferretti, Paolo Graziano and Lucia Anna Muscarella
Cancers 2025, 17(5), 730; https://doi.org/10.3390/cancers17050730 - 21 Feb 2025
Viewed by 1278
Abstract
Background/Objectives: The identification of driver mutations in NSCLC such as those in the EGFR and KRAS genes has revolutionized the understanding and management of many lung cancer patients and has opened up a new scenario in the early disease stages in terms of [...] Read more.
Background/Objectives: The identification of driver mutations in NSCLC such as those in the EGFR and KRAS genes has revolutionized the understanding and management of many lung cancer patients and has opened up a new scenario in the early disease stages in terms of therapeutic options (EGFR) and prognosis (KRAS). Data on prevalence rates and disease stage distributions of EGFR and KRAS mutations in surgically resected NSCLC are growing, but in Southern Italy, estimation is limited, since upfront EGFR testing in early-stage adenocarcinoma has been only recently introduced according to the current guidelines in clinical practice, whereas KRAS screening is usually uninvestigated in resected NSCLC. In this real-life study of a single institution in the Apulia Region, we provide an overview of the epidemiological distribution of EGFR and KRAS mutations in patients in Southern Italy with resected NSCLC, highlighting their prevalence, clinical significance, and correlation with demographic and pathological factors. A literature review was also performed to compare our findings with the most recent available data from the screening of Italian cohorts of advanced and surgically resected NSCLC patients. Methods: Data from 149 patients coming from Southern Italy with surgically resected NSCLC were retrospectively collected over a period of 16 years. EGFR and KRAS mutation screenings were performed and correlated with clinical and pathological data. Results: In total, 24 out of 149 NSCLC (16%) patients harbored an EGFR mutation. Exon 19 deletions and missense p.L858R mutations of the EGFR gene have quite similar frequencies (46%) and were more observed in never smokers (p < 0.001) and female (p < 0.001) patients with the adenocarcinoma histotype. KRAS gene mutations were detected in 31.5% of cases, with missense p.G12C (32%), p.G12V (28%), and p.G12D (17%) mutations as the most frequent ones. Neither EGFR nor KRAS mutational status were found to impact overall survival (OS) in our study cohort. Conclusions: Our findings improve the understanding of lung cancer genetics in a small and homogeneous area of Southern Italy and guide future research. The EGFR and KRAS mutations in NSCLC resected patients from Southern Italy showed a global similar incidence compared to other recently described Italian cohorts of advanced and early-stage NSCLC, with a higher frequency of exon19 EGFR deletions. No prognostic impact was observed for both EGFR and KRAS status, but additional investigations on a larger cohort are needed. Full article
(This article belongs to the Special Issue Modern Surgical Treatments for Thoracic Malignancies)
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11 pages, 279 KiB  
Article
Neoadjuvant Therapy in Robotic Lung Surgery: Elevating Surgical Complexity Without Compromising Outcomes
by Inés Serratosa, Carlos Déniz, Camilo Moreno, Iván Macia, Francisco Rivas, Anna Muñoz, Marina Paradela, Ernest Nadal, Miguel Mosteiro, Susana Padrones, Marta García, Tania Rodríguez-Martos, Judith Marcè and Amaia Ojanguren
Cancers 2024, 16(23), 3938; https://doi.org/10.3390/cancers16233938 - 25 Nov 2024
Viewed by 1259
Abstract
Background: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted thoracic surgery (RATS) is not fully characterized. Objective: [...] Read more.
Background: Neoadjuvant therapy, particularly the combination of chemotherapy and immunotherapy, has become standard in treating locally advanced non-small cell lung cancer (NSCLC). While this approach improves pathologic responses, its effect on postoperative outcomes following robotic-assisted thoracic surgery (RATS) is not fully characterized. Objective: This study aimed to evaluate the impact of neoadjuvant therapy on postoperative outcomes in patients undergoing RATS for NSCLC, focusing on operative time, conversion rates to open surgery, and postoperative complications. Methods: A retrospective cohort analysis was performed on patients who underwent RATS for NSCLC between February 2019 and August 2024. Propensity score matching was utilized to balance preoperative characteristics between the groups. The primary outcomes compared were operative time, conversion rates to open surgery, and postoperative complications, with statistical significance defined as p < 0.05. Results: A total of 253 patients were included in the analysis, of whom 23 received neoadjuvant therapy (either chemotherapy or chemoimmunotherapy) and 230 did not. The neoadjuvant group had significantly longer operative times (250 min vs. 221 min, p = 0.001) but there were no significant differences in conversion rates to open surgery (8.7% vs. 3.9%, p = 0.5). However, the neoadjuvant group showed a higher incidence of prolonged air leaks (>5 days) (39.13% vs. 35.21%, p < 0.001). Other parameters, such as hospital stay and chest drainage duration, showed no statistically significant differences between the groups (p = 0.860 and p = 0.760, respectively). Conclusions: These findings support the feasibility of robotic-assisted thoracic surgery following neoadjuvant therapy in NSCLC, suggesting that this approach may be safely integrated into clinical practice for selected patients. Further studies are needed to define patient selection criteria and optimize postoperative management, potentially guiding personalized treatment strategies in complex cases. Full article
(This article belongs to the Special Issue Modern Surgical Treatments for Thoracic Malignancies)
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