Thoracic Cancer最新文献

{"title":"Diffuse Pulmonary Meningotheliomatosis Presenting as Innumerable Pulmonary Micronodules: A Case Report.","authors":"Eitetsu Koh, Yasuo Sekine, Hodaka Oeda, Tadao Nakazawa","doi":"10.1111/1759-7714.70172","DOIUrl":"10.1111/1759-7714.70172","url":null,"abstract":"<p><p>Diffuse pulmonary meningotheliomatosis (DPM) is a rare lung condition characterized by widespread meningothelial-like nodules and may radiologically mimic metastatic or granulomatous disease. We report a 2019-onset case of a 44-year-old woman with incidentally detected, bilateral 1-2-mm pulmonary micronodules on screening CT. Laboratory tests and pulmonary function were normal. Owing to the minute, peripheral distribution of the nodules, bronchoscopic biopsy was not feasible, and diagnostic video-assisted thoracoscopic wedge resection was undertaken. Histology showed spindle-to-ovoid cells in whorled arrangements without atypia or mitoses. Immunohistochemistry revealed diffuse vimentin positivity and negativity for epithelial and neuroendocrine markers (EMA, cytokeratin AE1/AE3, SMA, chromogranin). Postoperative brain MRI showed no intracranial lesion. The patient has remained asymptomatic without radiologic progression over 3 years. This case underscores DPM as an uncommon yet important differential diagnosis of diffuse pulmonary micronodules and highlights the need for histopathologic confirmation when bronchoscopic sampling is impracticable. Where available, PR and SSTR2A immunostains may further support the diagnosis.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 19","pages":"e70172"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the SANO Trial: Reshaping Organ Preservation for Esophageal Cancer in the Era of Potent Neoadjuvant Therapies.","authors":"Jun Wang, Zhouguang Hui, Qingsong Pang","doi":"10.1111/1759-7714.70158","DOIUrl":"10.1111/1759-7714.70158","url":null,"abstract":"","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 19","pages":"e70158"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery of Grip Strength Over Time After Complete Resection of KRAS-Positive Lung Cancer With Hypertrophic Pulmonary Osteoarthropathy: A Case Report.","authors":"Takafumi Iguchi, Kensuke Kojima, Daiki Hayashi, Toshiteru Tokunaga, Hyungeun Yoon","doi":"10.1111/1759-7714.70170","DOIUrl":"10.1111/1759-7714.70170","url":null,"abstract":"<p><p>Hypertrophic pulmonary osteoarthropathy is a rare paraneoplastic syndrome affecting < 1% of patients with non-small cell lung cancer, characterized by clubbed fingers, periosteal proliferation, and arthritis. Although symptoms improve after treatment, objective functional recovery has not previously been reported. We present a 52-year-old male heavy smoker with right upper lobe adenocarcinoma and hypertrophic pulmonary osteoarthropathy causing profound grip strength impairment (5/2 right/left kilogram-force (kgf)). Genetic testing identified the KRAS G12C mutation. The patient underwent right upper lobectomy after which his arthralgia resolved immediately and grip strength recovered progressively (16/12 kgf, postoperative day 3; 40.9/32.9 kgf, 3 months), reaching normal adult levels. Periosteal changes initially persisted but resolved by 1 year. This case provides the first objective documentation of functional recovery in a patient with hypertrophic pulmonary osteoarthropathy, suggesting that impaired grip strength may be caused by joint inflammation and edema affecting bone-tendon attachments, rather than by muscle weakness alone. The KRAS G12C mutation may contribute to the development of hypertrophic pulmonary osteoarthropathy through upregulation of vascular endothelial growth factor via the Raf pathway. This case provides valuable insights into the pathophysiology of hypertrophic pulmonary osteoarthropathy and confirms that functional impairment is reversible with appropriate treatment.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 19","pages":"e70170"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Effectiveness of Uniport Anatomic Resections in Patients With Clinical Stage I Lung Cancer: An Observation Cohort Study.","authors":"Ching Feng Wu, Ming Ju Hsieh, Yueh Fu Fang, Yi Yu Lin, Diego Gonzalez Rivas, Ching Yang Wu","doi":"10.1111/1759-7714.70169","DOIUrl":"10.1111/1759-7714.70169","url":null,"abstract":"<p><strong>Objective: </strong>Although uniportal video-assisted thoracoscopic surgery (uVATS) is increasingly adopted for early-stage lung cancer, long-term survival data comparing different forms of anatomic resection remain limited. This study aimed to evaluate the long-term oncologic outcomes-specifically, 5-year disease-free survival (DFS) and overall survival (OS)-of patients with clinical stage I non-small cell lung cancer (NSCLC) who underwent uVATS segmentectomy or lobectomy. Secondary outcomes included perioperative parameters and complication rates.</p><p><strong>Method: </strong>We conducted a retrospective analysis of patients with clinical stage I NSCLC who underwent uVATS anatomical resection (lobectomy or segmentectomy) between January 2014 and December 2020. The primary endpoints were 5-year DFS and OS, while the secondary endpoints included operative time, drainage duration, hospital stay, conversion rates, and postoperative complications.</p><p><strong>Results: </strong>A total of 386 patients with clinical stage I NSCLC underwent uVATS anatomical resection, with 280 receiving lobectomy and 106 undergoing segmentectomy. The 5-year DFS and OS rates did not significantly differ between segmentectomy and lobectomy for patients with pathological stage IA tumors. Segmentectomy was associated with a shorter drainage duration. The overall conversion rate to multiple-port VATS or thoracotomy was 1.8%, with no 30-day surgical mortality observed. Prolonged air leaks were the most common complication.</p><p><strong>Conclusion: </strong>uVATS anatomical resection is an effective treatment option for clinical stage I NSCLC, offering comparable long-term survival outcomes for segmentectomy and lobectomy in selected patients. Further prospective studies are warranted to confirm these findings and optimize patient selection.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 19","pages":"e70169"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Atezolizumab, Bevacizumab, Carboplatin, and Paclitaxel Therapy in Patients With Genetic Alterations in Non-Small Cell Lung Cancer.","authors":"Tsunehiro Tanaka, Motohiro Tamiya, Akito Miyazaki, Kiyohide Komura, Shun Futamura, Takahisa Kawamura, Kei Kunimasa, Takako Inoue, Kazumi Nishino","doi":"10.1111/1759-7714.70162","DOIUrl":"10.1111/1759-7714.70162","url":null,"abstract":"<p><strong>Background: </strong>The IMpower150 trial demonstrated the efficacy of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) therapy in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC). However, its efficacy in patients with NSCLC harboring other genetic alterations in real-world settings remains unclear. This study aimed to retrospectively evaluate the efficacy of ABCP therapy in patients with NSCLC harboring other genetic alterations.</p><p><strong>Methods: </strong>We retrospectively analyzed 61 patients with advanced NSCLC (33 with EGFR mutations: EGFR group and 28 with other genetic alterations: other group) who received ABCP therapy between January 2019 and December 2023 at a single institution in Japan, and evaluated efficacy and toxicities.</p><p><strong>Results: </strong>Most baseline characteristics were similar except treatment timing (p < 0.001) in both groups. The median progression-free survival (PFS) was 4.5 vs. 5.1 months (p = 0.663), and the objective response rate (ORR) was 45.5% vs. 50.0% (p = 0.77) between the EGFR and other groups. In multivariate analysis, PD-L1 expression ≥ 50% was independently associated with longer PFS (HR 0.23, p < 0.001). Grade ≥ 3 adverse events were manageable and occurred at similar rates (51.5% vs. 53.6%) between the EGFR and other groups, and discontinuation was low (9.8%). Subgroup analysis for patients with KRAS mutation (n = 14) and anaplastic lymphoma kinase (ALK) fusion (n = 6) showed trends consistent with the overall cohort.</p><p><strong>Conclusions: </strong>ABCP therapy demonstrated efficacy and manageable toxicity in NSCLC patients in both groups. Notably, those with high PD-L1 expression (≥ 50%) may derive greater PFS benefit. Further confirmation in larger prospective trials is warranted.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 18","pages":"e70162"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracoscopic Closure of Alveolar Pleural Fistula by Application of Pleural Flap and Polymeric Sealant.","authors":"Alfonso Fiorelli, Noemi Maria Giorgiano, Angela Iovine, Antonella Tamburrino, Gaetana Messina","doi":"10.1111/1759-7714.70156","DOIUrl":"10.1111/1759-7714.70156","url":null,"abstract":"<p><p>Persistent air leaks due to alveolar pleural fistula following lung resection were a frustrating clinical condition for patients and clinicians, associated with a prolonged hospital stay and increased morbidity. Several surgical strategies have been reported over the years for the closure of alveolar fistula, but the best treatment was still debated. Herein, we reported the clinical case of a patient who experienced a persistent air leak due to alveolar-pleural fistula following thoracoscopic right upper lobectomy for the management of early lung cancer. The fistula was successfully closed by thoracoscopic application of a pleural flap and polymeric sealant. Our new strategy could turn out to be useful for surgeons when standard procedures for management of APF were unfeasible or difficult to perform. Obviously, our impression should be validated by future large studies in a prospective manner.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 17","pages":"e70156"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Stage-Specific Guideline Concordant Treatment in Small Cell Lung Cancer in Victoria, Australia.","authors":"Sanuki Tissera, Baki Billah, Md Nazmul Karim, Phillip Antippa, Robert Blum, Michelle Caldecott, Matthew Conron, Inger Olesen, Phil Parente, Gary Richardson, Evangeline Samuel, Katharine See, Craig Underhill, Gavin Wright, Javier Torres, Sagun Parakh, Tom John, John Zalcberg, Wasek Faisal, Susan Harden, Rob G Stirling","doi":"10.1111/1759-7714.70161","DOIUrl":"10.1111/1759-7714.70161","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer accounts for 9% of all cancer diagnoses in Australia with a 5-year survival rate of 26%. Small cell lung cancer (SCLC) is a more aggressive subtype of lung cancer, representing 15% of all lung cancer cases and a 5-year survival of 11.1%. This study aims to assess the extent of guideline concordant treatment (GCT) delivery for SCLC in Victoria, identify patient, clinical, and hospital factors influencing GCT receipt, and evaluate its impact on survival.</p><p><strong>Methods: </strong>Data were obtained from the Victorian Lung Cancer Registry (VLCR) in Victoria, Australia (n = 1769). Descriptive statistics were used to summarie patient and disease characteristics by treatment type, including GCT, non-GCT, and no/declined treatment. Statistical analyses included multiple logistic regression, Cox regression, and Kaplan-Meier survival estimates.</p><p><strong>Results: </strong>78.1% received GCT, 10.5% received non-GCT, and 11.5% had no treatment. Older age, poor performance status, and advanced cancer stage were associated with a lower likelihood of receiving GCT. Patients who received stage-specific GCT had a 60% lower mortality risk compared to those who received non-GCT treatment.</p><p><strong>Conclusion: </strong>This study highlights significant variation in the receipt of guideline concordant treatment for SCLC, with older age, poorer performance status, and advanced cancer stage reducing the likelihood of GCT. Given the survival benefits associated with GCT, addressing barriers to its delivery is essential to improving outcomes for SCLC patients in Victoria.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 17","pages":"e70161"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-Arm Cone Beam CT-Guided Preoperative Microcoil Pulmonary Ground Glass Nodule Localization: Diagnostic and Surgical Advantage.","authors":"Carlo Altomare, Rebecca Casati, Giuseppina Pacella, Laura Olivieri, Angelo Tirabasso, Annamaria Altomare, Luca Frasca, Filippo Longo, Pierfilippo Crucitti, Eliodoro Faiella, Bruno Beomonte Zobel, Rosario Francesco Grasso","doi":"10.1111/1759-7714.70152","DOIUrl":"10.1111/1759-7714.70152","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the effectiveness and safety of C-arm cone beam CT (CBCT)-guided microcoil localization combined with uniportal video-assisted thoracoscopic surgery (VATS) for the management of small, difficult-to-localize ground-glass opacities (GGOs) and sub-solid nodules in the lungs.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 13 patients with single, small, peripheral, non-subpleural GGOs or SSN. All patients underwent successful microcoil localization using CB-CT guidance followed by uniportal VATS resection. A microcoil was positioned partly in the lung parenchyma and partly in the extra-pleural space to assist in intraoperative localization. We evaluated the rate of correct microcoil placement and the technical success of the resection.</p><p><strong>Results: </strong>Microcoil placement was successfully performed in all patients, with an average procedure time of 28.8 ± 10.8 min. The mean nodule size was 9.9 ± 5.4 mm, and 76.9% of the nodules were classified as ground-glass opacities. No intraparenchymal bleeding was observed, and four patients (30.8%) experienced pneumothorax, all of which were self-limited and required no intervention or coil repositioning. The uniVATS resection success rate was 100%.</p><p><strong>Conclusion: </strong>CBCT-guided microcoil localization, with partial placement of the coil in the extra-pleural space, proved to be a highly effective technique for the localization and resection of small pulmonary nodules. The procedure demonstrated high accuracy, minimal complications, reduction of procedural time, and short hospital stays. Intraoperative fluoroscopy was never necessary, with a high reduction in radiation exposure for the patient and the operator. Further studies with larger populations and longer follow-ups are needed to validate these findings.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 17","pages":"e70152"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the Application of Three-Dimensional Reconstruction in Thoracic Surgery: A Comprehensive Review.","authors":"Guihu Lin, Ruzhen Li, Xiao Li, Dawei Wang, Xiuyuan Chen","doi":"10.1111/1759-7714.70159","DOIUrl":"https://doi.org/10.1111/1759-7714.70159","url":null,"abstract":"<p><p>This review presents a comprehensive overview of recent advancements and clinical applications of three-dimensional (3D) reconstruction technology in thoracic surgery, with a focus on lung cancer surgery. The widespread adoption of chest computed tomography (CT) screening has increased the detection rates of early-stage lung cancers, facilitating a transition from traditional lobectomy to parenchymal-sparing sublobar resections, such as segmentectomy, which demand higher anatomical precision. 3D reconstruction technology significantly improves tumor localization, as well as vascular and bronchial visualization, thereby enhancing surgical accuracy and safety. Its key applications encompass preoperative planning, intraoperative navigation, real-time localization, vascular and airway visualization, and postoperative pulmonary function assessment, collectively contributing to improved surgical outcomes and patient prognosis. Recent innovations in artificial intelligence have streamlined and automated the reconstruction process, leading to reduced operative times and increased accuracy. However, challenges persist, including image quality limitations, algorithm robustness, and limited high-quality clinical evidence. Future integration with emerging technologies such as virtual reality and augmented reality holds promise for achieving personalized, intelligent thoracic surgical procedures. This review aims to systematically evaluate the clinical value of 3D reconstruction technology and explore its future development directions.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 17","pages":"e70159"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12397496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There Is More Than Meets the Eye With Ground Glass Nodules: Is It Too Early to Adopt Sublobar Resection as Standard of Care for Early Stage Lung Adenocarcinoma?","authors":"Charles Leduc","doi":"10.1111/1759-7714.70165","DOIUrl":"10.1111/1759-7714.70165","url":null,"abstract":"<p><p>Sublobar resection is gaining popularity for the treatment of early stage lung adenocarcinoma, often presenting as a ground glass nodule on CT. Ground glass nodules are, however, a heterogeneous group of lesions, and they are too often equated with in situ or lepidic pattern adenocarcinoma. Many of these lesions actually harbor high grade micropapillary pattern and display spread through air spaces (STAS) on histology; features that are associated with increased recurrence following sublobar resection. Post hoc analysis of the impact of STAS in the JCOG0802 and CALGB140503 trials is currently ongoing and has yet to be published. This brief report aims to raise awareness of these pertinent issues that should be considered when approaching the management of early stage lung adenocarcinoma.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 18","pages":"e70165"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}