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Surgical Treatment for Lung Cancer
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Surgical Treatment for Lung Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 25 September 2025 | Viewed by 3847

Special Issue Editors

Dr. Piotr Gabryel

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
Interests: lung cancer surgery; minimally invasive surgery; enhanced recovery after surgery; quality improvement; lung transplantation
Dr. Cezary Piwkowski

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
Interests: mediastinal tumors; lung cancer; lung transplantation; minimally invasive surgery; multimodality treatment
Dr. Marek Ochman

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego 62 Street, 60-569 Poznan, Poland
Interests: lung cancer; lung transplantation; multimodality treatment; perioperative care

Special Issue Information

Dear Colleagues,

Despite significant progress, lung cancer remains a leading cause of cancer-related mortality worldwide. This Special Issue will explore advancements and ongoing challenges in the surgical treatment of lung cancer. Our aim is to compile high-quality research that addresses current limitations and innovates surgical practices to improve patient outcomes.

The Special Issue seeks to cover a broad spectrum of topics, including, but not limited to, surgical techniques, perioperative care, and multimodality treatment. We will discuss minimally invasive surgery (video-assisted and robotic-assisted thoracic surgery), the role, limitations, and technical advancements of segmental resections, and surgical treatment in advanced lung cancer. Additionally, we will focus on the role of Enhanced Recovery After Surgery (ERAS) protocols in preventing postoperative complications and the integration of immunotherapy with surgery for improvement of lung cancer treatment results. We encourage submissions that provide insights into overcoming core problems, such as the limitations of existing surgical methods and the effective combination of multimodal therapies. By bringing together leading experts and the latest research, this Special Issue aims to advance the standards of surgical care in lung cancer treatment and foster collaborations that lead to transformative clinical practices.

We invite researchers and clinicians to contribute original research articles and reviews that reflect the current state of the art and pave the way for future innovations in lung cancer surgery.

Dr. Piotr Gabryel
Dr. Cezary Piwkowski
Dr. Marek Ochman
Guest Editors

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 short 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. Journal of Clinical Medicine 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 2600 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
  • surgery
  • minimally invasive surgery
  • immunotherapy
  • enhanced recovery after surgery
  • segmentectomy

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

Published Papers (4 papers)

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Research

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13 pages, 1041 KiB  
Article
Surgery for Pancoast Tumors in Multimodality Setting: Analysis of Outcomes and Risk Factors
by Giorgio Cannone, Eleonora Faccioli, Alberto Busetto, Luigi Lione, Giuseppe Maggioni, Samuele Nicotra, Marco Schiavon, Alessandro Rebusso, Giovanni Comacchio, Marco Mammana, Matteo Sepulcri, Giulia Pasello, Fiorella Calabrese, Andrea Dell’Amore and Federico Rea
J. Clin. Med. 2025, 14(8), 2758; https://doi.org/10.3390/jcm14082758 - 17 Apr 2025
Viewed by 330
Abstract
Background: Pancoast tumors are a rare subset of lung cancers that require a multimodal approach (induction chemoradiotherapy and surgery), best performed in highly specialized centers. This study analyzes the outcomes and prognostic factors in patients treated at a high-volume center over an [...] Read more.
Background: Pancoast tumors are a rare subset of lung cancers that require a multimodal approach (induction chemoradiotherapy and surgery), best performed in highly specialized centers. This study analyzes the outcomes and prognostic factors in patients treated at a high-volume center over an extended period. Methods: We retrospectively reviewed 43 patients who underwent surgery for Pancoast tumors, following induction treatment between 2005 and 2023. Survival was estimated using the Kaplan–Meier method, and a Cox proportional hazards model was applied to identify prognostic factors (significance level p = 0.05). Results: The median patient age was 63 years, with over 90% having a disease at stage III or higher. Induction chemoradiotherapy was administered to 79% of the patients, achieving a pathological complete response (PCR) in 23% of the patients. The median overall survival (OS) was 37 months, with 1–3 and 5-year OS rates of 71%, 52%, and 41%, respectively. The median disease-free survival (DFS) was 38 months, with 1-, 3-, and 5-year DFS rates of 72%, 62%, and 35%, respectively. A pathological complete response (PCR) and vertebral and/or vascular infiltration significantly influenced recurrence and mortality risk. Conclusions: Trimodal therapy still offers the best short- and long-term outcomes in patients with Pancoast tumors. Future strategies incorporating tyrosine kinase inhibitors and anti-PD1/PD-L1 may improve outcomes for patients by increasing PCR rates and improving disease control. Full article
(This article belongs to the Special Issue Surgical Treatment for Lung Cancer)
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12 pages, 212 KiB  
Article
Impact of Pulmonary Ligament Resection in Upper Lobectomies: A Multicenter Matched Cohort Study
by Alessio Campisi, Andrea Dell’Amore, Wentao Fang, Gabriella Roca, Stefano Silvestrin, Samuele Nicotra, Yang Chen, Piotr Gabryel, Magdalena Sielewicz, Cezary Piwkowski, Eleonora La Rocca, Alexandro Patirelis, Vincenzo Ambrogi, Riccardo Giovannetti, Federico Rea and Maurizio Infante
J. Clin. Med. 2024, 13(22), 6950; https://doi.org/10.3390/jcm13226950 - 18 Nov 2024
Viewed by 764
Abstract
Background: Division of the pulmonary ligament is standard in lower lobectomies, but its application in upper lobectomies remains controversial due to potential complications like atelectasis and bronchial kinking. This retrospective matched cohort study aimed to evaluate the efficacy and safety of ligament [...] Read more.
Background: Division of the pulmonary ligament is standard in lower lobectomies, but its application in upper lobectomies remains controversial due to potential complications like atelectasis and bronchial kinking. This retrospective matched cohort study aimed to evaluate the efficacy and safety of ligament resection in upper lobectomies for oncological purposes. Methods: From January 2015 to December 2020, 988 patients who underwent minimally invasive upper lobectomies across multiple centers were identified. They were categorized into ligament resection and no ligament resection groups, with propensity score matching (PSM) to minimize confounding factors. Endpoints included operative time, pleural effusion, complications (frequency and Clavien–Dindo scores), chest drainage removal, length of stay, pleural space, collapse rate, and bronchial kinking. Results: Following PSM, 276 patients were included in each group, with no significant differences in baseline characteristics. Ligament resection correlated with longer operative times, increased lymphadenectomy sampling at station #9 (p < 0.001), and a bigger change in the bronchial angle (p < 0.001). No statistically significant differences were observed for the other endpoints. Conclusions: Ligament resection during upper lobectomy may impact the bronchial angle without immediate postoperative outcome changes. Further research is necessary to comprehensively assess the risks and benefits of ligament resection in upper lobectomies for neoplastic disease. Full article
(This article belongs to the Special Issue Surgical Treatment for Lung Cancer)
13 pages, 1526 KiB  
Article
Can Artificial Intelligence Help Us in the Evaluation of Coronary Artery Calcification Scores by Acting as a Prognosticator in Patients That Are Operated on Due to Non-Small Cell Lung Cancer? A Pivotal Study
by Tomasz Marjanski, Michal Chmielecki, Kaja Klein-Awerjanow, Wojciech Cytawa, Patrycja Ciepialowska, Andrii Bilyk, Rafal Peksa and Magdalena Dudek
J. Clin. Med. 2024, 13(21), 6579; https://doi.org/10.3390/jcm13216579 - 1 Nov 2024
Viewed by 1206
Abstract
Background: Non-small cell lung cancer (NSCLC) is the leading cause of death from malignancies, and surgical resection is the most effective form of treatment. Coronary artery disease (CAD) is a common comorbidity in patients with NSCLC. A coronary artery calcium (CAC) score correlates [...] Read more.
Background: Non-small cell lung cancer (NSCLC) is the leading cause of death from malignancies, and surgical resection is the most effective form of treatment. Coronary artery disease (CAD) is a common comorbidity in patients with NSCLC. A coronary artery calcium (CAC) score correlates with the extent of CAD. We aimed to test whether an automated assessment of CAC scores helps to identify the population of patients with a higher risk of postoperative complications and worse overall survival (OS) after the surgical treatment of NSCLC. Methods: In this retrospective cohort study, the data of the patients who were surgically treated for NSCLC were matched with the reassessed preoperative CT images. The postoperative complication rates and overall survival were analyzed. The CAC score was evaluated automatically using the Syngo.via Siemens Healthcare software. Cardiac age was assessed according to Hoff et al. 2001. The prognosticators of postoperative complications and of OS were tested. Results: The data of 193 patients with complete data, an adherence to the inclusion and exclusion criteria, and that were operated between 2018 and 2019, were included. Cardiac age was a predictor of the cardiovascular and pulmonary complications rate (95%CI −0.007–0.203, p = 0.066, beta coefficient 0.098). In a multivariable stepwise regression analysis, operative access was a predictor of cardiovascular and pulmonary complications (95%CI −0.290–−0.111, p < 0.001, beta coefficient −0.200), cardiovascular complications (95%CI −0.161–−0.022, p = 0.011, beta coefficient −0.036), and the general complication rate (95%CI −0.370–−0.194, p < 0.001, beta coefficient −0.286). Kaplan–Meier curves were separated in the survival analysis of groups of patients with a cardiac age 0–69 years vs. an age of 70+ (92 vs. 92 patients) (in Cox regression analysis, HR = 1.678, 95%CI 0.847–3.292 p = 0.138). Conclusions: An automated CAC score assessment may be a potential and clinically meaningful prognosticator of both postoperative complications and OS in patients that are operated on due to NSCLC. Further studies are required. Full article
(This article belongs to the Special Issue Surgical Treatment for Lung Cancer)
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Review

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9 pages, 206 KiB  
Review
The Role of Sublobar Resection in Early-Stage Non-Small-Cell Lung Cancer
by Francesco Petrella, Andrea Cara, Enrico Mario Cassina, Sara Degiovanni, Lidia Libretti, Emanuele Pirondini, Federico Raveglia, Antonio Tuoro and Sara Vaquer
J. Clin. Med. 2024, 13(17), 5277; https://doi.org/10.3390/jcm13175277 - 5 Sep 2024
Viewed by 1049
Abstract
The results of a prospective, multi-institutional randomized trial developed to assess the equality of sublobar resection versus standard lobectomy were first published in 1995. They concluded that, compared with lobectomy, sublobar resections did not show any significant improvement either in terms of postoperative [...] Read more.
The results of a prospective, multi-institutional randomized trial developed to assess the equality of sublobar resection versus standard lobectomy were first published in 1995. They concluded that, compared with lobectomy, sublobar resections did not show any significant improvement either in terms of postoperative morbidity and mortality nor in terms of late post-resectional cardiorespiratory function. Moreover, due to the higher mortality and local recurrence rate related to sublobar resection, lobectomy had to be judged as the best surgical option for patients diagnosed with peripheral early-stage non-small-cell lung cancer. Since then, lobectomy has been considered the best surgical option for fit patients suffering from early-stage non-small cell lung cancer. In 2022 and 2023, three non-inferiority randomized trials were published, comparing lobectomy with the sublobar resection in T1a N0 patients whose tumors were up to 2 cm in size. Although presenting some important differences, all three trials met their primary endpoints, disclosing the non-inferiority of sublobar resections in terms of overall and disease-free survival. This narrative review aims to compare the newly published results of these trials as well as to report results from recent non-randomized studies on this topic. Full article
(This article belongs to the Special Issue Surgical Treatment for Lung Cancer)
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