Innovative Approaches in Lung Cancer Treatment

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (25 November 2023) | Viewed by 8960

Special Issue Editors


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Guest Editor
Division of Thoracic Oncology, European Institute of Oncology (IEO), Milano, Italy
Interests: minimally invasive thoracic surgery; robotic surgery; thoracic surgery; thoracic oncology; lung cancer; thoracic neoplasms
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Guest Editor
Department of Thoracic Surgery, Nancy Regional University Hospital, 5, allée du Morvan, 54500 Vandoeuvre-lès-Nancy, France
Interests: minimally invasive thoracic surgery; robotic surgery; navigation bronchoscopy; thoracic oncology; lung cancer; thoracic neoplasms

Special Issue Information

Dear Colleagues,

Background: In the last 15 years, we witnessed significant progress in the field of thoracic surgery and oncology.

Aim and scope: We aim to publish articles describing innovative approaches in the treatment of lung cancer, such as minimally invasive and robotic surgery, electromagnetic navigation bronchoscopy, 3D techniques or medical innovative treatments.

History: With the advent of new technologies, methods and treatments, we witnessed important improvements in immediate post-operative clinical conditions of the patients undergoing lung surgery and, more generally, improvements in the middle and long-term prognosis of these patients.

Cutting-edge research: The advantages of minimally invasive surgery, endobronchial diagnosis or target therapy and immunotherapy in the treatment of advanced lung cancer have been investigated for the management of lung cancer.

What kind of paper we are looking for: We encourage the submission of manuscripts that describe an innovative approach in the treatment of lung cancer, both surgical and medical.

Dr. Antonio Mazzella
Prof. Dr. Stéphane Renaud
Guest Editors

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Keywords

  • lung cancer
  • minimally invasive surgery
  • robotic surgery
  • innovative approaches
  • navigation bronchoscopy
  • innovative medical treatments
  • future perspectives

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Published Papers (4 papers)

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Research

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14 pages, 1874 KiB  
Article
Recurrence-Free Survival in Early and Locally Advanced Large Cell Neuroendocrine Carcinoma of the Lung after Complete Tumor Resection
by Barbara Altieri, Anna La Salvia, Roberta Modica, Francesca Marciello, Olaf Mercier, Pier Luigi Filosso, Bertrand Richard de Latour, Dario Giuffrida, Severo Campione, Gianluca Guggino, Elie Fadel, Mauro Papotti, Annamaria Colao, Jean-Yves Scoazec, Eric Baudin and Antongiulio Faggiano
J. Pers. Med. 2023, 13(2), 330; https://doi.org/10.3390/jpm13020330 - 15 Feb 2023
Cited by 2 | Viewed by 1831
Abstract
Background: Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in [...] Read more.
Background: Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in this subgroup of patients and to identify potential prognostic markers. Methods: Retrospective multicenter study including patients with pure LCNEC stage I-III and R0 resection. Clinicopathological characteristics, RFS, and disease-specific survival (DSS) were evaluated. Univariate and multivariate analyses were performed. Results: 39 patients (M:F = 26:13), with a median age of 64 years (44–83), were included. Lobectomy (69.2%), bilobectomy (5.1%), pneumonectomy (18%), and wedge resection (7.7%) were performed mostly associated with lymphadenectomy. Adjuvant therapy included platinum-based chemotherapy and/or radiotherapy in 58.9% of cases. After a median follow-up of 44 (4–169) months, the median RFS was 39 months with 1-, 2- and 5-year RFS rates of 60.0%, 54.6%, and 44.9%, respectively. Median DSS was 72 months with a 1-, 2- and 5-year rate of 86.8, 75.9, and 57.4%, respectively. At multivariate analysis, age (cut-off 65 years old) and pN status were independent prognostic factors for both RFS (HR = 4.19, 95%CI = 1.46–12.07, p = 0.008 and HR = 13.56, 95%CI 2.45–74.89, p = 0.003, respectively) and DSS (HR = 9.30, 95%CI 2.23–38.83, p = 0.002 and HR = 11.88, 95%CI 2.28–61.84, p = 0.003, respectively). Conclusion: After R0 resection of LCNEC, half of the patients recurred mostly within the first two years of follow-up. Age and lymph node metastasis could help to stratify patients for adjuvant therapy. Full article
(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)
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13 pages, 1884 KiB  
Article
Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon?
by Antonio Mazzella, Shehab Mohamed, Patrick Maisonneuve, Giulia Sedda, Andrea Cara, Monica Casiraghi, Francesco Petrella, Stefano Maria Donghi, Giorgio Lo Iacono and Lorenzo Spaggiari
J. Pers. Med. 2023, 13(2), 193; https://doi.org/10.3390/jpm13020193 - 21 Jan 2023
Cited by 5 | Viewed by 2050
Abstract
Objective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginning [...] Read more.
Objective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginning of his robotic activity as first operator from January 2021 to June 2022. We evaluated several pre-, intra- and postoperative parameters concerning patients and intraoperative cardiovascular and respiratory outcomes of the surgeon, recorded during surgical interventions, in order to evaluate his cardiovascular stress. We used cumulative sum control charts (CUSUM) to analyze the learning curve. Results: A total of 72 lung lobectomies were performed by a single surgeon in this period. Analyzing the CUSUM of several parameters, the inflection point identifying the transition beyond the surgeon learning phase was reached at cases 28, 22, 27 and 33 when considering operating time, mean heart rate, max heart rate and mean respiratory rate, respectively. Conclusions: The learning curve for robotic lobectomy seems to be safe and feasible with a correct robotic training program. The analysis of a single surgeon from the beginning of his robotic activity demonstrates that confidence, competence, dexterity and security are achieved after about 20–30 procedures, without compromising efficiency and oncological radicality. Full article
(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)
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Review

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11 pages, 1198 KiB  
Review
Surgical Approaches to Pancoast Tumors
by Francesco Petrella, Monica Casiraghi, Luca Bertolaccini and Lorenzo Spaggiari
J. Pers. Med. 2023, 13(7), 1168; https://doi.org/10.3390/jpm13071168 - 21 Jul 2023
Cited by 1 | Viewed by 2656
Abstract
Pancoast tumors, also defined as superior sulcus tumors, still represent a complex clinical condition requiring high technical surgical skills within more articulated multimodality treatment. The morbidity and mortality rates after Pancoast tumor treatments range from 10 to 55% and 0 to 7%, respectively, [...] Read more.
Pancoast tumors, also defined as superior sulcus tumors, still represent a complex clinical condition requiring high technical surgical skills within more articulated multimodality treatment. The morbidity and mortality rates after Pancoast tumor treatments range from 10 to 55% and 0 to 7%, respectively, and the 5-year survival rate has significantly improved in recent years thanks to the advancement of treatments. Although a multimodality approach combining chemotherapy, radiotherapy, and surgery allows for radical resection and effective local control in the vast majority of patients, many patients cannot receive surgical resection or complete the whole programmed therapeutic regimen. Systemic relapse, particularly cerebral recurrence, still poses a significant issue in this cohort of patients. Surgical resection still plays a pivotal role within the multimodality approach. Here, we focus on surgical approaches to both anterior and posterior Pancoast tumors: the anterior transclavicular approach (Dartevelle); the anterior transmanubrial approach (Grunenwald–Spaggiari); the anterior trap-door approach (Masaoka, Nomori); the posterior approach (Shaw–Paulson); the hemiclamshell approach; and hybrid approaches. Global clinical condition, tumor histology, and long-term perspectives should always be taken into consideration when embarking on such a demanding oncologic scenario. Full article
(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)
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Other

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7 pages, 211 KiB  
Opinion
A Practical Assessment of the Postoperative Management in Lung Cancer Surgery
by Luca Bertolaccini, Shehab Mohamed, Clarissa Uslenghi, Matteo Chiari, Lara Girelli, Giorgio Lo Iacono and Lorenzo Spaggiari
J. Pers. Med. 2023, 13(2), 358; https://doi.org/10.3390/jpm13020358 - 18 Feb 2023
Viewed by 1724
Abstract
Postoperative management after major and minor thoracic surgeries is crucial for patient recovery and can be challenging. Major thoracic surgeries, such as extensive pulmonary resections, especially in patients with poor health status, may require intensive surveillance, particularly during the first 24–72 h after [...] Read more.
Postoperative management after major and minor thoracic surgeries is crucial for patient recovery and can be challenging. Major thoracic surgeries, such as extensive pulmonary resections, especially in patients with poor health status, may require intensive surveillance, particularly during the first 24–72 h after surgery. Moreover, thanks to the demographic development and medical progress in perioperative medicine, more patients with comorbidities undergoing thoracic procedures require proper management in the postoperative period to improve prognosis and decrease hospital stay. Here, we summarize the main thoracic postoperative complications in order to clarify how to prevent them through a series of standardized procedures. Full article
(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)
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