The Current Status of Lung Cancer Surgery

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Thoracic Oncology".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 5215

Special Issue Editors


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Guest Editor
Thoracic Surgery, A, Gemelli University Hospital Foundation IRCCS, 00168 Rome, Italy
Interests: lung neoplasm; thymic tumors; mediastinum; thoracic cancer treatments; surgery; non-small cell lung cancer; minimally invasive surgery
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Guest Editor
Thoracic Surgery Unit, Policlinico – San Marco Hospital, University of Catania, Catania, Italy
Interests: lung cancer; thymic tumors; mediastinum; robotic-assisted surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Lung cancer remains one of most impactful tumors around the world in terms of incidence, mortality, and society costs.

Surgical treatment is the indicated treatment for early stages, but it also plays a role in the multidisciplinary management of advanced stages, as a therapeutic option in the case of hilar/mediastinal involvement or oligo-metastatic disease.

Moreover, especially in recent years, the development of minimally invasive techniques was permitted to extend some indication in fragile patients and improve post-operative outcomes and the patients’ quality of life.

However, one of the most important points to be clarified regards the impact of surgery on oncological outcomes, and how it should be modulated based on tumor and patient characteristics.

This Special Issue aims to collect studies on the role of lung cancer surgery in terms of post-operative and oncological outcome, with particular interest on peri- and operative management.

Dr. Marco Chiappetta
Dr. Giacomo Cusumano
Guest Editors

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Keywords

  • non-small cell lung cancer
  • surgery
  • minimally invasive techniques
  • lung cancer resection
  • complications
  • lung cancer survival

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Published Papers (3 papers)

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Editorial

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4 pages, 200 KiB  
Editorial
Surgery for Non-Small Cell Lung Cancer in the Personalized Therapy Era
by Marco Chiappetta, Carolina Sassorossi and Giacomo Cusumano
Curr. Oncol. 2023, 30(8), 7773-7776; https://doi.org/10.3390/curroncol30080563 - 21 Aug 2023
Viewed by 1750
Abstract
Lung cancer remains one of the tumours with the highest incidence and the poorest
prognosis, with an estimated incidence of more than 220,000 cases with 135,000 cancerrelated
deaths annually in the United States [1,2].[...] Full article
(This article belongs to the Special Issue The Current Status of Lung Cancer Surgery)

Research

Jump to: Editorial

11 pages, 579 KiB  
Article
Low-Malignant-Potential Adenocarcinoma: A Histological Category with a Significantly Better Prognosis than Other Solid Adenocarcinomas at IA Stage
by Marco Chiappetta, Alessandra Cancellieri, Filippo Lococo, Elisa Meacci, Carolina Sassorossi, Maria Teresa Congedo, Qianqian Zhang, Diomira Tabacco, Isabella Sperduti and Stefano Margaritora
Curr. Oncol. 2025, 32(4), 217; https://doi.org/10.3390/curroncol32040217 - 9 Apr 2025
Viewed by 263
Abstract
Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or [...] Read more.
Introduction: Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or visceral pleural invasion, spread through air spaces (STAS), necrosis and >1 mitosis per 2 mm2. The aim of this study is to validate, with regard to cancer-specific survival (CSS) and disease-free survival (DFS), the proposed definition of LMP adenocarcinoma in an independent external cohort of lung adenocarcinoma patients having undergone surgical resection, and having presented with a long follow-up period. Methods: Clinicopathological characteristics of patients who underwent lung resection for adenocarcinoma from 1 January 2005 to 31 December 2014 were retrospectively analyzed. Patients with ground-glass opacity (GGO) and part-solid tumors, minimally invasive adenocarcinoma (MIA), adenocarcinoma in situ (AIS), tumors ≥5 cm in size, nodal involvement and/or distant metastases, patients who underwent neoadjuvant treatment, and those who had an incomplete follow-up or a follow-up shorter than 60 months were excluded. The proposed criteria for low-malignant-potential adenocarcinoma (LMPA) were tumor size ≤ 3 cm, invasive size ≥ 0,5 cm, lepidic growth ≥ 15%, and absence of the following: mitosis (>1 per 2 mm2), mucinous subtype, angiolymphatic invasion, visceral pleural invasion, spread through air spaces (STAS) and tumor necrosis. End points were disease-free survival (DFS) and cancer-specific survival (CSS). The log-rank test was used to assess differences between subgroups. Results: Out of 80 patients meeting the proposed criteria, 14 (17.5%) had the LMPA characteristics defined. The mean follow-up time was 67 ± 39 months. A total of 19 patients died, all in the non-LMPA category, and 33 patients experienced recurrence: 4 (28.5%) with LMPA and 29 (43.9%) with non-LMPA. Log-rank analysis showed 100% 10-year CSS for patients with LMPA and 77.4% for patients without LMPA, with this difference being statistically significant (p-value = 0.047). Univariate analysis showed a significant association with the cStage (AJCC eighth edition), both for CSS (p value = 0.005) and DFS (p-value = 0.003). LMPA classification did not show a statistically significant impact on CSS and DFS, likely due to the limited number of events (CSS p-value = 0.232 and DFS p-value = 0.213). No statistical association was found for CSS and DFS with pT, the number of resected nodes (< or >10) or the number of resected N2 stations (< or >2). Conclusions: Our study confirmed the prognostic role of LMPA features, with a low risk of recurrence and a good CSS and DFS. The criteria for diagnosis are replicable and feasible for application. The clinical implications of these findings, such as pre-operative prediction and surveillance scheduling, may be the topic of future prospective studies. Full article
(This article belongs to the Special Issue The Current Status of Lung Cancer Surgery)
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17 pages, 283 KiB  
Article
Pneumonectomy for Primary Lung Tumors and Pulmonary Metastases: A Comprehensive Study of Postoperative Morbidity, Early Mortality, and Preoperative Clinical Prognostic Factors
by Konstantinos Grapatsas, Hruy Menghesha, Fabian Dörr, Natalie Baldes, Martin Schuler, Martin Stuschke, Kaid Darwiche, Christian Taube and Servet Bölükbas
Curr. Oncol. 2023, 30(11), 9458-9474; https://doi.org/10.3390/curroncol30110685 - 25 Oct 2023
Cited by 3 | Viewed by 2521
Abstract
Background: Pneumonectomy is a major surgical resection that still remains a high-risk operation. The current study aims to investigate perioperative risk factors for postoperative morbidity and early mortality after pneumonectomy for thoracic malignancies. Methods: We retrospectively analyzed all patients who underwent pneumonectomy for [...] Read more.
Background: Pneumonectomy is a major surgical resection that still remains a high-risk operation. The current study aims to investigate perioperative risk factors for postoperative morbidity and early mortality after pneumonectomy for thoracic malignancies. Methods: We retrospectively analyzed all patients who underwent pneumonectomy for thoracic malignancies at our institution between 2014 and 2022. Complications were assessed up to 30 days after the operation. Mortality for any reason was recorded after 30 days and 90 days. Results: A total of 145 out of 169 patients undergoing pneumonectomy were included in this study. The postoperative 30-day complication rate was 41.4%. The 30-day-mortality was 8.3%, and 90-day-mortality 17.2%. The presence of cardiovascular comorbidities was a risk factor for major cardiopulmonary complications (54.2% vs. 13.2%, p < 0.01). Postoperative bronchus stump insufficiency (OR: 11.883, 95% CI: 1.288–109.591, p = 0.029) and American Society of Anesthesiologists (ASA) score 4 (OR: 3.023, 95% CI: 1.028–8.892, p = 0.044) were independent factors for early mortality. Conclusion: Pneumonectomy for thoracic malignancies remains a high-risk major lung resection with significant postoperative morbidity and mortality. Attention should be paid to the preoperative selection of patients. Full article
(This article belongs to the Special Issue The Current Status of Lung Cancer Surgery)
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