Objective performance indicators provide a novel, quantitative method to evaluate surgeon proficiency in robotic lobectomy training.

Objective: Current evaluation of robotic surgeon proficiency relies on subjective assessment. The robotic platform collects highly granular kinematic data on surgeon activity, known as objective performance indicators (OPIs). We sought to compare surgeon proficiency during lobectomies across training levels using OPIs.

Low-Dose Computed Tomography Lung Cancer Screening for Individuals Who Have Never Smoked: A Review of Recent Updates in Taiwan and the United States.

Low-dose computed tomography (LDCT) screening is widely recognized as an effective tool for the early detection of lung cancer. However, its efficacy among individuals without a history of smoking continues to attract interest. Currently, nearly all lung cancer screening guidelines provide recommendations exclusively for individuals who currently smoke or have a history of smoking.

Clearing the air: Empowering high-risk adults with digital tools for smoking cessation and lung cancer screening adoption.

Background: Even though lung cancer screening decreases mortality, uptake remain low. Research has focused on integrating smoking cessation into lung cancer screening programs rather than providing lung cancer screening education to eligible adults. Engaging individuals who are at high-risk for lung cancer and educating them about lung cancer screening is a critical next step.

The implementation of an electronic symptom management system to monitor postoperative pain in thoracic surgery patients: A multicenter evaluation.

Objective: Few studies have evaluated postoperative recovery of patients after thoracic surgery using patient-reported outcome measures. This multi-institutional study analyzed postoperative pain and opioid use among patients undergoing thoracic surgery based on patient-reported outcome measures data collected through an electronic symptom management system.

Methods: The electronic symptom management system is a multi-symptom questionnaire based on a Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events that is integrated into the electronic health record and administered via the patient portal.

Segmentectomy vs Lobectomy for Patients With 2- to 3-cm Non-Small Cell Lung Cancer.

Background: Two studies recently demonstrated the noninferiority of sublobar resection to lobectomy in patients with T1a-bN0M0 non-small cell lung cancer (NSCLC). However, whether segmentectomy is associated with similar oncologic outcomes to lobectomy for patients with node-negative T1c tumors (ie, those 2-3 cm) remains unknown.

Research Question: What is the survival of patients undergoing segmentectomy vs those undergoing lobectomy for T1cN0M0 NSCLC (defined as NSCLC presenting with tumors of 2 to 3 cm not involving the pleura or main bronchi that has not spread to lymph nodes or distant sites)?

Study Design And Methods: Patients in the National Cancer Database (2010-2020) who underwent segmentectomy or lobectomy for clinical T1cN0M0 NSCLC were identified for analysis.

Treatment of Unsuspected T4 Non-Small Cell Lung Cancer With Additional Intrapulmonary Nodules.

Background: There is limited consensus on the optimal treatment for patients with non-small cell lung cancer (NSCLC) who are found to have additional intrapulmonary nodules in a different ipsilateral lobe (unsuspected pT4-Add) during surgical intervention. This study compared outcomes of patients with unsuspected pT4-Add NSCLC after resection of the primary site tumor with or without resection of additional nodules.

Methods: Patients who underwent surgical intervention for cT1-3 N0-1 M0 NSCLC with unsuspected pT4-Add disease in the National Cancer Database (2010-2015) were included.

Temporal Trends in the Utilization and Survival Outcomes of Lobar, Segmental, and Wedge Resection for Early-Stage NSCLC, 2004 to 2020.

Introduction: Although lobectomy has long been the standard of surgical treatment for early-stage NSCLC, segmental and wedge resections have become another option often used over the past two decades.

Methods: To examine the trends over time in the utilization, quality, and overall survival (OS) differences of lobectomy, segmentectomy, and wedge resection, we performed an observational, population-level study of 76,466 patients with T1 or T2 N0M0 NSCLC tumors 2 cm or less in size in the National Cancer Database, from 2004 to 2020. To compare the OS of the three treatments, we used inverse probability of treatment weighting to analyze a subgroup of cases with nodal examination and minimal comorbidity burden.

Outcomes After Surgical Management of Early-Stage Lung Cancer in Octogenarians: An In-Depth Analysis of a Nationally Representative Cohort.

Introduction: As the United States population ages more octogenarians are undergoing surgical resection for lung cancer. We aimed to provide an updated and expanded assessment of age-related risks associated with surgical resections for early-stage NSCLC.

Methods: The Surveillance, Epidemiology, and End Results and Medicare databases were queried for stage IA NSCLC cases treated by surgery between 2006 and 2018.

Assessing Lung Cancer Screening Eligibility of Patients With Lung Cancer in the Boston Lung Cancer Study: An Analysis of 7186 Lung Cancer Cases.

Background: This study sought to evaluate the proportion of patients with lung cancer who would have qualified for lung cancer screening under different eligibility criteria in the Boston Lung Cancer Study (BLCS).

Methods: BLCS participants with a diagnosis of lung cancer from 1992 to 2024 were identified for analysis. The study evaluated the proportion of patients who would have qualified for screening under the 2021 US Preventive Services Task Force (USPSTF) (age 50-80 years, ≥20-pack-years, <15 quit-years), 20-year duration (age 50-80 years, ≥20-year smoking duration, <15 quit-years), American Cancer Society (age 50-80 years, ≥20-pack-years), National Comprehensive Cancer Network (NCCN) category A (age ≥50 years, ≥20-pack-years), and NCCN category AB (age ≥50 years, ≥20-pack-years or ≥20-year smoking duration) guidelines.

The Impact of Food Insecurity on the Management and Survival of Stage I-III Esophageal Cancer.

Background: Food insecurity is associated with poor health outcomes; however, the connection with cancer care is not well understood. This study aimed to evaluate the impact of county-level food insecurity on the surgical management and survival of patients with esophageal cancer.

Methods: Patients with stage I to III esophageal cancer were identified from Surveillance Epidemiology and End Results data (2010-2016).

The 2021 US Preventive Services Task Force lung cancer screening eligibility criteria disproportionately exclude younger Black patients with lung cancer.

Background: The 2021 US Preventive Services Task Force (USPSTF) lung cancer screening guideline may continue to exclude many younger Black individuals who have not yet accumulated enough smoking pack-years to be eligible for screening. The objective of this study was to evaluate the proportions of Black and White patients with lung cancer, stratified by age at diagnosis, who would have been eligible for lung cancer screening.

Methods: Incident lung cancer cases among Black and White individuals aged 50-80 years with a smoking history in the Southern Community Cohort Study (SCCS) were identified for analysis.

Primary lung signet-ring cell carcinoma: a national analysis.

Background: Primary lung signet-ring cell carcinoma (LSRCC) is a rare form of aggressive lung cancer whose clinical features remain inadequately discerned. The objective of this study was to evaluate the clinicopathological characteristics and independent prognostic factors of primary LSRCC.

Methods: Overall survival (OS) of patients with LSRCC, lung adenocarcinoma (LAC), and lung mucinous adenocarcinoma (LMAC) in the National Cancer Database from 2004 to 2018 was evaluated using Kaplan-Meier and multivariable Cox proportional hazards modeling.

Safety and Optimizing Ergonomics for Cardiothoracic Surgeons.

Cardiothoracic surgery, demanding in nature, often results in surgeons suffering from musculoskeletal injuries, causing chronic pain and leading to premature retirement. A significant majority report experiencing pain, exacerbated by minimally invasive techniques such as video-assisted thoracoscopic surgery. Despite this, many surgeons delay seeking medical assistance.

Act1 drives chemoresistance via regulation of antioxidant RNA metabolism and redox homeostasis.

The IL-17 receptor adaptor molecule Act1, an RNA-binding protein, plays a critical role in IL-17-mediated cancer progression. Here, we report a novel mechanism of how IL-17/Act1 induces chemoresistance by modulating redox homeostasis through epitranscriptomic regulation of antioxidant RNA metabolism. Transcriptome-wide mapping of direct Act1-RNA interactions revealed that Act1 binds to the 5'UTR of antioxidant mRNAs and Wilms' tumor 1-associating protein (WTAP), a key regulator in m6A methyltransferase complex.

Early Detection and Interception of Lung Cancer.

Recent advances in lung cancer treatment have led to dramatic improvements in 5-year survival rates. And yet, lung cancer remains the leading cause of cancer-related mortality, in large part, because it is often diagnosed at an advanced stage, when cure is no longer possible. Lung cancer screening (LCS) is essential for intercepting the disease at an earlier stage.

Pack-Year Smoking History: An Inadequate and Biased Measure to Determine Lung Cancer Screening Eligibility.

Purpose: Pack-year smoking history is an imperfect and biased measure of cumulative tobacco exposure. The use of pack-year smoking history to determine lung cancer screening eligibility in the current US Preventive Services Task Force (USPSTF) guideline may unintentionally exclude many high-risk individuals, especially those from racial and ethnic minority groups. It is unclear whether using a smoking duration cutoff instead of a smoking pack-year cutoff would improve the selection of individuals for screening.