Analysis and prediction of pathological risk factors for lung cancer by plasma metabolomics.

Background: Common pathological risk factors for lung cancer include lymphovascular invasion (LVI), spread through air space (STAS) and perineural invasion (PNI). They are important factors that cause tumor recurrence after surgery, and also reference indices to determine the scope of surgical resection. At present, there is a lack of effective methods for preoperative judgment of the type and number of risk factors.

Expert Consensus on Subxiphoid and Subcostal Arch Thoracoscopic Resection for the Treatment of Thymoma.

Surgery is the primary treatment for thymoma. Although subxiphoid and subcostal arch thoracoscopic thymoma surgery is widely used, there is currently a lack of consensus regarding its use, nor have standards been established. Based on the surgical experience of many domestic thoracic surgery centers, the Department of Thoracic Surgery of Tangdu Hospital of Air Force Medical University has formulated this expert consensus regarding key clinical issues related to thoracoscopic thymoma surgery, including preoperative evaluation, surgical indications, preoperative preparation, surgical details, perioperative management, postoperative treatment, and follow-up.

Surgical Outcomes With Neoadjuvant Durvalumab Plus Chemotherapy Followed by Adjuvant Durvalumab in Resectable NSCLC.

Introduction: In AEGEAN, perioperative durvalumab plus neoadjuvant chemotherapy, versus neoadjuvant chemotherapy alone, significantly improved event-free survival (p = 0.004) and pathologic complete response (p < 0.001; primary end points; modified intention-to-treat [mITT] population, which excluded patients with known EGFR or ALK aberrations) with a manageable safety profile in patients with resectable (R)-NSCLC.

Prognostic Value of 18F-FDG PET/CT in Neoadjuvant PD-1 Inhibitor-treated NSCLC: A Five-year Follow-up Study.

Background: Neoadjuvant immunotherapy has shown promising short-term outcomes of perioperative treatments for resectable non-small cell lung cancer (NSCLC) and is expected to release long-term survival benefits. Here, we reported the long-term prognostic value of 18F-FDG PET/CT over ∼a 5-year follow-up.

Patients And Methods: A total of 35 patients with NSCLC (29 males and 6 females; median age, 62 y) received 2 doses of sintilimab, followed by complete tumor resection and PET/CT scans at baseline and post-neoadjuvant stages.

Cell Death and Senescence-Based Molecular Classification and an Individualized Prediction Model for Lung Adenocarcinoma.

The exploration of cell death and cellular senescence (CDS) in cancer has been an area of interest, yet a systematic evaluation of CDS features and their interactions in lung adenocarcinoma (LUAD) to understand tumor heterogeneity, tumor microenvironment (TME) characteristics, and patient clinical outcomes is previously uncharted. Our study characterized the activities and interconnections of 21 CDS features in 1788 LUAD cases across 15 cohorts, employing unsupervised clustering to categorize patients into three CDS subtypes with distinct TME profiles. The CDS index (CDSI), derived from principal component analysis, was developed to assess individual tumor CDS regulation patterns.

Uniportal video-assisted thoracoscopic surgery does not increase recurrence rates following pneumonectomy in non-small cell lung cancer: a retrospective study from the National Cancer Center of China.

Background: The safety, feasibility, and potential benefits of uniportal video-assisted thoracoscopic surgery (U-VATS) pneumonectomy remain to be investigated. This study aimed to evaluate the postoperative outcomes, survival prognosis, and recurrence patterns in patients undergoing U-VATS versus those undergoing open pneumonectomy. The feasibility of U-VATS pneumonectomy in patients receiving neoadjuvant systemic therapy was also assessed.

Neoadjuvant chemotherapy with albumin-bound paclitaxel plus cisplatin and capecitabine for locally advanced esophageal squamous cell carcinoma: a phase 2 clinical trial.

Background: Neoadjuvant chemotherapy is recommended for locally advanced esophageal squamous cell carcinoma (ESCC), but more effective regimens are needed to improve the outcomes. This study evaluates the efficacy and safety of neoadjuvant chemotherapy with albumin-bound paclitaxel plus cisplatin and capecitabine (APC regimen) for locally advanced ESCC.

Materials And Methods: This prospective single-center phase 2 clinical study involved patients with locally advanced ESCC (T2-4aN±M0) from May 19, 2020 to September 1, 2022.

Three-field vs two-field lymphadenectomy in thoracic ESCC patients: a multicenter randomized study (NST 1503).

Background: 3-field lymph node dissection (3FL) frequently lead to much more perioperative complications than 2-field lymph node dissection (2FL). This study was designed as a non-inferiority trial to evaluate whether 3FL could be omitted without compromising overall survival (OS) and disease-free survival (DFS) in the patients with resectable thoracic esophageal squamous cell cancer (ESCC) and negative right recurrent laryngeal nerve lymph nodes (RRLN-LNs).

Methods: cT1b-3N0-1M0 thoracic ESCC patients were managed in 3 arms during open or minimally invasive McKeown esophagectomy according to the results of frozen section examination for RRLN-LNs: if positive, direct 3FL (RRLN[+]-3FL); if negative, 2FL (RRLN[-]-2FL) or 3FL (RRLN[-]-3FL) by randomization.

Predicting survival in small cell lung cancer patients undergoing various treatments: a machine learning approach.

Background: Small cell lung cancer (SCLC) is highly metastatic, accounting for 1.796 million global cancer-related deaths in 2020, with no established standard care. This study aimed to assess treatment effects on SCLC patient survival across stages and develop a machine learning-based survival prediction tool for accurate overall survival (OS) estimation.

Clinical practice guidelines for perioperative multimodality treatment of non-small cell lung cancer.

Background: Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide. Although the early stage non-small cell lung cancer (NSCLC) presents a relatively good prognosis, a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages. Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival.

Multidisciplinary expert consensus on diagnosis and treatment of multiple lung cancers.

The rising incidence of multiple lung cancers (MLCs), encompassing multiple primary lung cancers (MPLCs) and intrapulmonary metastasis (IPM), poses two significant clinical challenges. First, distinguishing between MPLC and IPM remains difficult due to insufficiently accurate criteria and ambiguous integration of genetic testing. Second, standardized therapeutic protocols are still lacking.

Multi-omics analyses reveal distinct molecular characteristics and transformation mechanisms of stage I-III micropapillary lung adenocarcinoma.

The micropapillary (MIP) pattern is a high-grade histological subtype of lung adenocarcinoma (LUAD) with poor prognosis. In this study, surgically resected tumor samples from 101 patients with stage I-III MIP-LUAD (MIP ≥30%) were microdissected to separate MIP components from non-MIP components, all of which underwent RNA and DNA whole-exome sequencing (WES). The genomic and transcriptomic landscapes of MIP and non-MIP components within MIP-enriched tumor tissues demonstrated remarkable similarities, notably marked by high epidermal growth factor receptor (EGFR) alteration frequencies.

A single-cell atlas reveals immune heterogeneity in anti-PD-1-treated non-small cell lung cancer.

Anti-PD-(L)1 treatment is standard for non-small cell lung cancer (NSCLC), but patients show variable responses to the same regimen. The tumor immune microenvironment (TIME) is associated with immunotherapy response, yet the heterogeneous underlying therapeutic outcomes remain underexplored. We applied single-cell RNA and TCR sequencing (scRNA/TCR-seq) to analyze surgical tumor samples from 234 NSCLC patients post-neoadjuvant chemo-immunotherapy.

Real-world long-term outcomes of non-small cell lung cancer patients undergoing neoadjuvant treatment with or without immune checkpoint inhibitors.

Background: Immune checkpoint inhibitors (ICIs) have been included in various neoadjuvant therapy (NAT) regimens for non-small cell lung cancer (NSCLC). However, due to the relatively short period for the use of ICIs in NAT, patients' clinical outcomes with different regimens are uncertain. Our study aims to examine the efficacy of neoadjuvant immunotherapy (NAIT) for NSCLC patients and compare the overall survival (OS) and event-free survival (EFS) of patients receiving different NAT regimens.

Lobectomy plus lobe-specific lymphadenectomy as the minimum standards of curative resection for hypermetabolic clinical stage IA non-small cell lung cancer.

Background: The results of three modern randomized controlled trials have proved sublobar resection as an effective procedure for early-stage non-small cell lung cancer (NSCLC) up to 2 cm. We aimed to examine whether sublobar resection is oncologically feasible and what constitutes adequate lymph node assessment for hypermetabolic clinical stage IA (cIA) NSCLC.

Methods: A single-center retrospective study was conducted in 589 patients who underwent lobectomy (n=526) or sublobar resection (n=63) for hypermetabolic cIA NSCLC [maximum standardized uptake value (SUVmax) ≥2.

The utility and feasibility of three-dimensional reconstruction in surgical planning for multiple pulmonary nodules: a prospective self-controlled study.

Background: Three-dimensional (3D) is a useful tool for visualizing computed tomography (CT) scans, facilitating a clearer understanding of the spatial relationships between pulmonary lesions and the branching architecture of the bronchi and blood vessels. Several studies have demonstrated the benefit of preoperative 3D reconstruction in terms of intraoperative safety and short-term surgical outcomes after thoracoscopic surgery. However, evidence regarding the impact of 3D reconstruction on surgical planning of anatomical partial lobectomy (APL) is still lacking.

Machine learning-based radiomics for guiding lymph node dissection in clinical stage I lung adenocarcinoma: a multicenter retrospective study.

Background: Preoperative assessment of lymph node status is critical in managing lung cancer, as it directly impacts the surgical approach and treatment planning. However, in clinical stage I lung adenocarcinoma (LUAD), determining lymph node metastasis (LNM) is often challenging due to the limited sensitivity of conventional imaging modalities, such as computed tomography (CT) and positron emission tomography/CT (PET/CT). This study aimed to establish an effective radiomics prediction model using multicenter data for early assessment of LNM risk in patients with clinical stage I LUAD.

Single-cell RNA sequencing and spatial transcriptomics of esophageal squamous cell carcinoma with lymph node metastases.

Esophageal squamous cell carcinoma (ESCC) patients often face a grim prognosis due to lymph node metastasis. However, a comprehensive understanding of the cellular and molecular characteristics of metastatic lymph nodes in ESCC remains elusive. In this study involving 12 metastatic ESCC patients, we employed single-cell sequencing, spatial transcriptomics (ST), and multiplex immunohistochemistry (mIHC) to explore the spatial and molecular attributes of primary tumor samples, adjacent tissues, metastatic and non-metastatic lymph nodes.

Prediction and analysis of the tumor invasiveness of pulmonary ground-glass nodules based on metabolomics.

In recent years, the incidence of ground-glass nodular lung adenocarcinoma has gradually increased. Preoperative evaluation of the tumor invasiveness is very important, but there is a lack of effective methods. Plasma samples of ground-glass nodular lung adenocarcinoma and healthy volunteers were collected.

A novel computational model ITHCS for enhanced prognostic risk stratification in ESCC by correcting for intratumor heterogeneity.

Intratumor heterogeneity significantly challenges the accuracy of existing prognostic models for esophageal squamous cell carcinoma (ESCC) by introducing biases related to the varied genetic and molecular landscapes within tumors. Traditional models, relying on single-sample, single-region bulk RNA sequencing, fall short of capturing the complexity of intratumor heterogeneity. To fill this gap, we developed a computational model for intratumor heterogeneity corrected signature (ITHCS) by employing both multiregion bulk and single-cell RNA sequencing to pinpoint genes that exhibit consistent expression patterns across different tumor regions but vary significantly among patients.

Predictive value of longitudinal systemic inflammatory markers for pathologic response to neoadjuvant PD-1 blockade in resectable non-small cell lung cancer.

Background: Identifying biomarkers to predict responses for neoadjuvant immunotherapy in resectable non-small cell lung cancer (NSCLC) is under intensive study. Considering the interplay between cancer, inflammation, and immunosuppression, we hypothesized that circulating and imaging inflammatory markers could serve as indicators of anti-tumor immune responses, and thus conducting an exploratory study to reveal the predictive value of combining longitudinal systemic inflammatory markers in stratifying pathologic response to neoadjuvant sintilimab.

Methods: We retrospectively reviewed 36 patients (29 male and seven female) with NSCLC (stage IA-IIIB) who underwent pre- and post-treatment peripheral blood tests and F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) scans before and after two cycles of neoadjuvant sintilimab (registration number: ChiCTR-OIC-17013726).

Risk of treatment-related toxicity from EGFR tyrosine kinase inhibitors: a systematic review and network meta-analysis of randomized clinical trials in -mutant non-small cell lung cancer.

Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are effective for non-small cell lung cancer (NSCLC) patients with -mutation, while their toxicity profiles are non-negligible and inconsistent. This study aimed to assess the toxicity intensity and profiles of different EGFR-TKIs in NSCLC patients with -mutation.

Methods: This random-effect Bayesian framed network meta-analysis (NMA) only included exclusively randomized clinical trials with demonstrated evidence on safety of EGFR-TKIs in NSCLC patients with EGFR-mutation.

IL-1 receptor-associated kinase 3 (IRAK3) in lung adenocarcinoma predicts prognosis and immunotherapy resistance: involvement of multiple inflammation-related pathways.

Background: Lung cancer is a globally prevailing malignancy, and the predominant histological subtype is lung adenocarcinoma (LUAD). IL-1 receptor-associated kinase 3 () has been identified in connection with innate immune and inflammatory response. The aim of this study is to investigate the impact of on prognosis and immunotherapy efficacy in LUAD, which remains incompletely elucidated.

Establishment of a survival predictive model for patients with two synchronous multiple primary lung cancers: a multicenter cohort analysis.

Background: The prognostic predictors of the synchronous multiple primary lung cancer (SMPLC) still remain unclear, and there is a lack of studies on the prognosis of SMPLC patients excluding those with multifocal ground-glass/lepidic (GG/L) nodules. The aim of this study is to develop an effective model for predicting survival of SMPLC patients.

Methods: In this multicenter cohort study, a total of 831 SMPLC patients presenting for lung cancer resection from January 2004 to January 2018 at five institutions were included for developing and validating a nomogram model.