Thoracic Cancer最新文献

{"title":"Atypical Behavior in a Typical Carcinoid: When Minimal Proliferation Meets Lympho-Vascular Invasion-A Case Report.","authors":"Qilian Wang, Xi Chen, Sicheng Zhou, Guowei Che","doi":"10.1111/1759-7714.70347","DOIUrl":"10.1111/1759-7714.70347","url":null,"abstract":"<p><p>Typical carcinoid tumors (TC) are a low-grade neuroendocrine tumor characterized by low proliferation activity and an overall favorable prognosis. Lympho-vascular invasion is uncommon in TC and is more frequently associated with atypical carcinoid. We reported a 46-year-old non-smoking woman who underwent right lower lobectomy for a right pulmonary hilar mass after multidisciplinary team (MDT) evaluation (cT1cN0M0, AJCC 9th edition, IA3). Postoperative histopathological examination confirmed typical carcinoid tumor with a low Ki-67 proliferation index (< 2%), and no tumor necrosis was identified, fulfilling the diagnostic criteria for typical carcinoid according to the current WHO classification of thoracic tumors. Unexpectedly, focal lympho-vascular invasion in the form of tumor emboli was identified. Additionally, the resected lung showed caseating granulomatous inflammation with acid-fast bacilli, suggestive of a non-tuberculous mycobacteria (NTM) infection; however, species-level identification was not performed. No lymph node metastasis was detected (pT1cN0M0, AJCC 9th edition, IA3). The patient had minimal pleural effusion on the surgical side postoperatively, and no signs of recurrence or metastasis have been detected during 20 months of follow-up to date. This report highlights a pathological discordance between the low proliferation index and the presence of lympho-vascular invasion in TC. The concomitant granulomatous inflammation may have contributed to diagnostic complexity, although a causal relationship cannot be established. This case underscores the importance of careful histopathological evaluation for invasive features in typical carcinoid tumors, even in the context of low proliferative activity. Surgical treatment alone might be safe in this specific scenario.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70347"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537006","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":"Molecular-Based Risk Prediction Models for Recurrence After Curative Treatment of Early-Stage Lung Cancer: A Systematic Review and Meta-Analysis.","authors":"Aaron Ling, Evangeline Samuel, Rahini Mahendran, John Zalcberg, Rob G Stirling","doi":"10.1111/1759-7714.70345","DOIUrl":"10.1111/1759-7714.70345","url":null,"abstract":"<p><p>Recurrence after curative treatment remains a major challenge in early-stage non-small cell lung cancer (NSCLC). Molecular-based prediction models may improve risk stratification and support personalized surveillance strategies. To identify and evaluate molecular-based risk prediction models for recurrence and survival following curative treatment of early-stage NSCLC. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and a published PROSPERO protocol. MEDLINE, EMBASE, and the Cochrane Library were searched for studies published between January 2000 and December 2023. Eligible studies reported performance metrics of molecular-based models predicting recurrence-free survival, cancer-specific survival, or overall survival following curative treatment for NSCLC. Data extraction was performed using the CHARMS framework, risk of bias was assessed using PROBAST, and model performance metrics were pooled using random-effects meta-analysis. Of 2447 records identified, five studies met the inclusion criteria. All models used Cox proportional hazards regression. Molecular predictors included mRNA expression profiles (n = 3), long noncoding RNAs (n = 1), and DNA methylation biomarkers (n = 1). Internal validation studies reported AUC values ranging from 0.66 to 0.89, with a pooled AUC of 0.77 (95% CI = 0.66-0.90; I² = 88.4%). Two externally validated models reported AUC values of 0.68-0.74, with a pooled AUC of 0.72 (95% CI = 0.68-0.75; I² = 0%). Two studies were considered high risk of bias due to inappropriate handling of missing data. Molecular-based prediction models demonstrate moderate-to-good discriminative performance for recurrence and survival in early-stage NSCLC. However, broader external validation and improved methodological rigor are required before routine clinical implementation. Trial Registration: PROSPERO identifier: CRD42024599641.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70345"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449710","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":"Tumor Necrosis on Routine Pretreatment CT as a Potential Prognostic Marker in Advanced NSCLC Treated With Immune Checkpoint Inhibitor Monotherapy: A Two-Center Retrospective Study.","authors":"Eiji Takeuchi, Hirokazu Ogino, Kensuke Kondo, Yoshio Okano, Hiroki Takahashi, Kaori Nii, Yugo Matsumura, Takuya Ishida, Seiya Ichihara, Michihiro Kunishige, Naoki Kadota, Hisanori Machida, Nobuo Hatakeyama, Keishi Naruse, Seidai Sato, Hiroshi Nokihara, Tsutomu Shinohara, Yasuhiko Nishioka","doi":"10.1111/1759-7714.70363","DOIUrl":"10.1111/1759-7714.70363","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of CT-detected tumor necrosis in advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor (ICI) monotherapy remains unclear. This two-center retrospective study investigated whether tumor necrosis on pretreatment CT independently predicts overall survival (OS).</p><p><strong>Methods: </strong>A total of 151 advanced NSCLC patients who received ICI monotherapy between March 2016 and August 2021 at two Japanese institutions were retrospectively analyzed. Tumor necrosis was visually assessed and operationally defined as an intratumoral area of low attenuation or cavitary lesion ≥ 5 mm on pretreatment chest CT (contrast-enhanced in 113 patients [75%] and non-contrast in 38 [25%]). Cox regression analyses identified independent prognostic factors for OS, with internal validation using 1000 bootstrap resamples.</p><p><strong>Results: </strong>Among 151 patients (mean age 69 years; 90% with ECOG PS 0-1), 121 (80%) had CT-detected necrosis. Median OS was significantly shorter in necrosis-positive patients than in necrosis-negative patients (374 vs. 1035 days; log-rank p = 0.02). A multivariate Cox regression analysis identified tumor necrosis as an independent adverse prognostic factor (HR = 1.84, 95% CI = 1.03-3.30; p = 0.04), along with blood-based biomarkers, tumor size, and PD-L1 expression. The detection rate of necrosis differed between CT modalities (contrast-enhanced 84% vs. non-contrast 68%, p = 0.04).</p><p><strong>Conclusion: </strong>This exploratory two-center retrospective study indicates the potential of CT-detected tumor necrosis as a readily accessible prognostic marker in ICI-treated NSCLC. However, the results obtained require validation in larger, prospective, multicenter studies with standardized CT imaging protocols before clinical implementation.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70363"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593403","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":"Development and Internal Validation of a Patient-Level Diagnostic Model Integrating Folate Receptor-Positive Circulating Tumor Cells and Peripheral CD8 Count for Malignant-Versus-Benign Pathology Discrimination in a Pathology-Enriched Pulmonary Nodule Cohort.","authors":"Chunyan Zhang, Xiaoke Sun, Hongjian Su, Yaqian Liu, Li Gong, Xiaojie Ma, Weidong Zhang, Fang Sun","doi":"10.1111/1759-7714.70358","DOIUrl":"10.1111/1759-7714.70358","url":null,"abstract":"<p><strong>Background: </strong>In pathology-enriched referred hospital cohorts, stable radiologic-pathologic linkage is often unavailable, so patient-level malignant pathology may be a more reliable endpoint than lesion-specific malignancy. We aimed to develop and internally validate a blood-based model for patient-level malignant-versus-benign pathology discrimination.</p><p><strong>Methods: </strong>We retrospectively reviewed 283 consecutive eligible source records from 22 February 2023 to 12 May 2025. After excluding unclassifiable pathology, lesions > 30 mm when verifiable, and obvious extrapulmonary primary tumors, we defined a strict primary cohort. A prespecified complete-case logistic regression model including FR + CTC, peripheral CD8 count, age, and sex was developed and internally validated with bootstrap resampling.</p><p><strong>Results: </strong>The strict primary cohort included 234 patients (166 malignant, 68 benign). In the main model (n = 232), FR + CTC was associated with higher odds of malignant pathology (OR 1.31 per 1 FU/3 mL, 95% CI: 1.14-1.50; p < 0.001), whereas peripheral CD8 count was inversely associated (OR 0.50 per 100 cells/μL, 95% CI: 0.41-0.61; p < 0.001). Apparent and optimism-corrected AUCs were 0.877 and 0.867, respectively. Adding an adjudicated patient-level CT vascular sign yielded limited incremental value.</p><p><strong>Conclusion: </strong>In this retrospective single-center, pathology-enriched cohort, FR + CTC and peripheral CD8 provided useful internally validated discrimination for patient-level malignant pathology. The model requires external validation and setting-appropriate recalibration before broader clinical use.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70358"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580170","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":"Real-World Survival Over 25 Years in Extensive-Stage Small-Cell Lung Cancer: The Impact of Immune Checkpoint Inhibitors.","authors":"Ryo Ariyasu, Teruhisa Nemoto, Hirokazu Iso, Masahiro Ito, Kyujiro Nibuya, Syunsuke Fujishima, Mayu Sugai, Ryosuke Tsugitomi, Yoshiaki Amino, Ken Uchibori, Noriko Yanagitani, Makoto Nishio","doi":"10.1111/1759-7714.70316","DOIUrl":"10.1111/1759-7714.70316","url":null,"abstract":"<p><strong>Introduction: </strong>Therapeutic progress for extensive-stage small-cell lung cancer (ES-SCLC) has been limited. Although immune checkpoint inhibitors (ICIs) have been introduced, their real-world impact on survival remains uncertain. We evaluated 25-year survival trends and the association between ICI exposure and overall survival (OS).</p><p><strong>Methods: </strong>Consecutive ES-SCLC patients treated at a Japanese cancer center between April 1999 and March 2023 were retrospectively reviewed and grouped by diagnosis period: A (1999-2003), B (2004-2008), C (2009-2013), D (2014-2018), and E (2019-2023). OS from diagnosis to death was measured. Kaplan-Meier/log-rank tests and multivariable Cox models were used. Subgroup analyses included patients aged ≥ 75 years, with PS ≥ 2, and with brain metastases.</p><p><strong>Results: </strong>A total of 452 patients were included. Median OS in period A was 9.8 months and in periods B-E, it was 12.5, 13.4, 11.8, and 13.6 months; 2-year OS rates were 6.2%, 18.2%, 18.6%, 17.3%, and 28.9%, respectively. In multivariable analysis, PS ≥ 2 (HR 1.51), receipt of first-line therapy (HR 0.09), and ICI exposure (HR 0.73; p = 0.013) were independently associated with OS. ICI exposure was associated with longer OS (15.2 vs. 12.3 months; 2-year OS 32.1% vs. 15.9%; p < 0.005) among systemically treated patients. In subgroup analyses, ICI-associated HRs were 0.67 in patients aged ≥ 75 years, 0.69 in PS ≥ 2, and 0.63 in brain metastases.</p><p><strong>Conclusions: </strong>Real-world survival in ES-SCLC improved over 25 years. ICI exposure was independently associated with improved OS, as well as in clinically high-risk subgroups.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70316"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144927","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":"Single-Cell Analysis Identifies LYPD6B as a Tumor-Intrinsic Candidate Associated With Immunotherapy Nonresponse in Breast Cancer.","authors":"Yifei Wang, Haiwei Quan, Zhiguang Xu, Yixiang Wang, Zhibin Wang","doi":"10.1111/1759-7714.70311","DOIUrl":"10.1111/1759-7714.70311","url":null,"abstract":"<p><p>Immune checkpoint blockade (ICB) induces durable responses in a subset of breast cancer patients, yet many show limited benefit from anti-PD-1/PD-L1 therapy. Understanding differences in the tumor microenvironment (TME) and tumor-intrinsic immune evasion between responders (R) and nonresponders (NR) is key to improving outcomes. We integrated three public scRNA-seq datasets from PD-(L)1-treated breast cancer (51 patients; 327022 cells) and analyzed paired pre-/posttreatment samples. Compared to NR, R patients exhibited increased CD8⁺ T cell infiltration, enhanced interferon-response activity, and myeloid/B-cell remodeling. Pseudotime analysis showed T cells in R progressed from activation to cytotoxic differentiation and ultimately exhaustion, consistent with effective ICB response patterns. Through tumor-intrinsic screening, we identified LYPD6B-a membrane gene upregulated in NR cancer cells that suppresses antigen processing/presentation and IFNα/β signaling. Functional assays confirmed that LYPD6B ablation impairs proliferation, clonogenic growth, and induces apoptosis. Drug-repurposing analyses revealed venetoclax binds LYPD6B and recapitulates its antiproliferative effects. Immunohistochemistry (IHC) and pan-cancer analyses verified LYPD6B's tumor-cell localization, association with immune infiltration, and checkpoint expression. Collectively, LYPD6B emerges as a tumor-intrinsic mediator of immune evasion and PD-(L)1 resistance, representing a promising target for combination immunotherapy in breast cancer.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70311"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151709","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":"Heterogeneity of Cancer-Associated Fibroblasts and Precision Targeting Strategies for Cancer Therapy.","authors":"Yijie Wang, Guangyao Zhou, Pengpeng Zhang, Zhenfa Zhang, Lianmin Zhang","doi":"10.1111/1759-7714.70310","DOIUrl":"10.1111/1759-7714.70310","url":null,"abstract":"<p><p>Immune checkpoint blockade (ICB) has transformed cancer therapy, but its effect is often limited by immunosuppression and resistance mechanisms within the tumor microenvironment (TME). Cancer-associated fibroblasts (CAFs) represent a major stromal component of the TME. They exhibit substantial heterogeneity, dynamic plasticity, diverse cellular origins, and context-dependent activation states, which critically determine the safety and efficacy of CAF-targeted therapies. CAFs contribute to tumor immune evasion by remodeling the extracellular matrix, altering tissue mechanics and establishing structural barriers. In addition, CAFs release cytokines, chemokines, and exosomes to impair T-cell trafficking and function. They also interact with immune and myeloid cells, further reducing the efficacy of ICB. Therefore, CAF-targeted therapies are shifting from the strategy of extensive clearance to a more elaborate framework, which focuses on specific CAF subpopulations and their regulatory pathways, and combines specific strategies for subpopulations, functional reprogramming, and methods based on advanced delivery systems and diagnostic tools. Integrating spatial omics, single-cell technologies, and 3D culture systems can help us better understand the different states of CAFs and how they are distributed in space. This enables the identification of targetable CAF states, informs reprogramming strategies, supports rational combination design, and facilitates biomarker discovery. This review emphasizes the heterogeneity and plasticity of CAFs in tumor immunosuppression, and advocates a conceptual shift from static cellular identity to a dynamic state-niche-function framework.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70310"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057086","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":"Sarcomatoid Transformation of Pulmonary Mucinous Adenocarcinoma as a Mechanism of Immunotherapy Resistance.","authors":"Kensuke Yanai, Tomohiro Tanaka, Konomi Kimura, Shinji Hirose, Hiroki Watanabe, Takaaki Masuda, Ryo Suzuki, Kohei Kushiro, Naohiro Yanagimura, Shuhei Kondo, Koichiro Nozaki, Yu Saida, Miyuki Sato, Satoshi Watanabe, Hajime Umezu, Koichi Hagiwara, Toshiaki Kikuchi","doi":"10.1111/1759-7714.70327","DOIUrl":"10.1111/1759-7714.70327","url":null,"abstract":"<p><p>Histological transformation to sarcomatoid carcinoma is an extremely rare mechanism of resistance to tyrosine kinase inhibitors. Among adenocarcinoma subtypes, transformation of pulmonary invasive mucinous carcinoma (IMA) into other histological types has not previously been reported. We present the case of a 74-year-old man referred to our hospital with abnormal lung shadows. Chest computed tomography (CT) revealed extensive consolidation predominantly in the right lower lobe. Transbronchial biopsy specimens confirmed IMA, which was negative for thyroid transcription factor-1, and a BRAF D594G mutation was detected. As surgical resection was not feasible, first-line treatment with ipilimumab plus nivolumab combined with chemotherapy was initiated, resulting in a partial response. After 19 cycles of maintenance therapy, treatment was discontinued because of suspected interstitial lung disease (ILD). Thirteen months later, the patient developed radiographic worsening of ILD, for which oral prednisolone was initiated. Two months later, CT imaging revealed rapid disease progression, with enlargement of right supraclavicular, mediastinal, and abdominal lymph nodes. Re-biopsy of a mediastinal lymph node demonstrated sarcomatoid carcinoma positive for vimentin and pan-cytokeratin AE1/AE3. Genomic analyses again identified the BRAF D594G mutation, confirming sarcomatous transformation of the original IMA. The patient received two cycles of nab-paclitaxel plus carboplatin without response and subsequently died. These findings emphasize that clinicians should recognize that IMA may undergo sarcomatous transformation.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 12","pages":"e70327"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273210","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":"Preoperative Pulmonary Function and Postoperative Pulmonary Complications in Noncardiac Surgery: A Propensity Score-Weighted Analysis.","authors":"Sung Ae Cho, Hee Eun Kim, Moon Ok Lee","doi":"10.1111/1759-7714.70333","DOIUrl":"10.1111/1759-7714.70333","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) increase surgical morbidity and mortality. While the predictive value of preoperative pulmonary function tests (PFTs) in noncardiac surgery remains unclear, we evaluated whether abnormal PFT patterns and spirometric indices are independently associated with PPCs.</p><p><strong>Methods: </strong>We retrospectively analyzed adult patients undergoing noncardiac surgery under general or spinal anesthesia between June and November 2022 with preoperative spirometry. PFTs were classified as normal or abnormal using lower limit of normal criteria. PPCs within 7 postoperative days were defined using European Perioperative Clinical Outcome criteria. Associations were assessed using multivariable logistic regression before and after propensity score-based overlap weighting. Continuous spirometric indices were also analyzed.</p><p><strong>Results: </strong>Among 729 patients, 64 (8.8%) had abnormal PFTs. PPCs were significantly more frequent in the abnormal PFTs group (29.7% vs. 8.7%; p < 0.001). After overlap weighting, abnormal PFTs remained independently associated with PPCs (adjusted odds ratio [aOR] 4.05, 95% CI 1.72-9.53; p < 0.001), along with open surgery (aOR 8.94, 95% CI 2.38-33.59; p = 0.001). Lower FEV₁ and %FEV₁ were consistently associated with increased PPC risk across all models, whereas associations with FVC and FEV₁/FVC were inconsistent.</p><p><strong>Conclusions: </strong>Abnormal preoperative PFTs and reduced FEV₁ are independently associated with PPCs after noncardiac surgery. Preoperative spirometry aids perioperative risk stratification, particularly for invasive surgery.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 12","pages":"e70333"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303269","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":"Synchronous Surgical Therapy for Bilateral Multiple Pulmonary Nodules: A Single-Center Analysis of 108 Cases.","authors":"Huayu He, Jie Bai, Jizheng Tang, Yingze Ning, Wei He, Chutong Lin, Shanwu Ma, Tong Wang, Jingdi Wang, Jintao Song, Keyi Wang, Lili Zheng, Guangliang Qiang","doi":"10.1111/1759-7714.70320","DOIUrl":"10.1111/1759-7714.70320","url":null,"abstract":"<p><strong>Background: </strong>With the widespread use of low-dose computed tomography (LDCT), the detection rate of bilateral multiple pulmonary nodules (BMPNs) has increased significantly. Surgical treatment remains the main treatment for multiple pulmonary nodules (MPNs), and its therapeutic value for simultaneous BMPNs is becoming increasingly prominent. However, the safety and feasibility of synchronous bilateral surgery (SBS) remain underexplored. This study aimed to evaluate the perioperative outcomes and prognosis of patients who underwent SBS for multiple pulmonary nodules.</p><p><strong>Methods: </strong>We retrospectively analyzed the data from 108 patients who underwent synchronous bilateral resection for MPNs at Peking University Third Hospital between January 2015 and December 2025. Clinical, pathological, and perioperative data were collected. Postoperative complications were classified using the Clavien-Dindo system. Risk factors for postoperative complications were identified using a logistic regression analysis. Overall survival was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Among the 108 patients, 62.0% were female, and 79.6% were nonsmokers. The most common surgical combination was wedge resection combined with wedge resection (44.4%). The mean postoperative hospital stay was 6.55 ± 3.03 days. The most common complications were constipation (53.7%) and sleep disorders (51.9%), while severe complications occurred in fewer than 5% of the patients. No 30-day mortality or unplanned secondary surgery was observed. Prolonged chest tube drainage (> 3 days) was identified as an independent risk factor for grade ≥ 2 complications (p < 0.05). The 5-year overall survival rate was 92.3%.</p><p><strong>Conclusions: </strong>SBS for MPNs is safe and feasible in selected patients, with acceptable perioperative outcomes and favorable survival.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 11","pages":"e70320"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212562","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}