Interdisciplinary cardiovascular and thoracic surgery最新文献

{"title":"Stenosis of a novel frozen elephant trunk in a patient with chronic dissection.","authors":"Shigeto Tokunaga, Homare Okamura, Atsushi Yamaguchi","doi":"10.1093/icvts/ivag279","DOIUrl":"https://doi.org/10.1093/icvts/ivag279","url":null,"abstract":"<p><p>A partial elephant trunk (PET), a new type of frozen elephant trunk, was designed to prevent distal stent graft-induced new entry using a thinner nitinol wire with less radial force. We report a case of PET stenosis in chronic dissection. Total arch replacement was performed using a PET. After weaning from cardiopulmonary bypass, the lower-limb blood pressure decreased to 90% of the upper-limb blood pressure. Intraoperative transesophageal echocardiography revealed incomplete PET expansion, and on postoperative day 1, the lower-to-upper body blood pressure ratio further decreased to 70% due to PET stenosis at the steeply angulated arch. Emergency thoracic endovascular aortic repair was successfully performed, completely resolving the pressure gradient.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic outcomes of sublobar resection in non-small cell lung cancer ≤3 cm with adverse pathologic features.","authors":"Taeyoung Yun, Dongsun Lee, Ji Hyeon Park, Kwon Joong Na, Hyun Joo Lee, In Kyu Park, Chang Hyun Kang, Young Tae Kim, Samina Park","doi":"10.1093/icvts/ivag263","DOIUrl":"https://doi.org/10.1093/icvts/ivag263","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the association between resection extent and recurrence-free survival in patients with clinically node-negative NSCLC ≤3 cm with adverse pathologic features including visceral pleural invasion, spread through air spaces (STAS), or high-grade histology.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent curative-intent resection for cN0M0 NSCLC with pathologic tumor size ≤3 cm between 2017 and 2023. Patients were categorized into sublobar resection and lobectomy groups. Cox proportional hazards models were used to identify factors associated with recurrence-free survival. Propensity-score weighting was used to account for measured differences between the surgical groups, followed by weighted survival analyses within prespecified individual and combined adverse-feature subgroups.</p><p><strong>Results: </strong>Among 1,774 patients, 666 underwent sublobar resection and 1,108 underwent lobectomy. Visceral pleural invasion, STAS, and high-grade histology were independently associated with a higher risk of recurrence. Lobectomy was not independently associated with recurrence-free survival in multivariable analysis (HR, 1.17; 95% CI, 0.69-1.98, p = 0.562). In unadjusted subgroup analyses, recurrence-free survival did not significantly differ by resection extent among patients with visceral pleural invasion, STAS, or high-grade histology with similar findings in combined subgroups (p > 0.05). Weighting reduced the baseline imbalances, while the resulting survival curves remained largely overlapping across the individual adverse-feature subgroups.</p><p><strong>Conclusions: </strong>Visceral pleural invasion, STAS, and high-grade histology were independently associated with recurrence, whereas resection extent was not. The weighted analysis did not show a clear separation between surgical groups, although the present analysis was not designed to demonstrate comparable efficacy between the two surgical approaches.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EACTS Expert Consensus Document on Civil Aviation Following Cardiothoracic Surgery and Transcatheter Procedures.","authors":"Thomas Syburra, Edward D Nicol, Carlos A Mestres, Milos Matkovic, Joanna d'Arcy, Denis Bron, Filip Casselman, Martin Czerny, Stephen Fremes, Norbert Guettler, Paul Philipp Heinisch, Stuart Mitchell, Joao Pedro Monteiro, John Pepper, Francesco Petrella, Ulrich Rosendahl, Barbara A Rosser, Dan Spiegelstein, Milan Milojevic","doi":"10.1093/icvts/ivag217","DOIUrl":"10.1093/icvts/ivag217","url":null,"abstract":"<p><p>Civil aviation medicine and cardiothoracic surgery intersect at a point where individual clinical outcomes and public safety are tightly coupled. Professional aircrew and other safety-critical aviation personnel must meet legally defined medical standards that are designed around an engineering approach to risk, including a low annual tolerance for sudden incapacitation, whereas passengers and cabin crew are exposed to the physiological constraints of the flight environment (hypobaric hypoxia, gas expansion, limited access to medical care, immobility, and circadian rhythm disruption). Yet, the evidence base guiding fitness-to-fly decisions after cardiothoracic procedures, treatment of aortic disease, and contemporary transcatheter interventions remains sparse and unevenly distributed across procedures, licensing classes, and operational contexts. This European Association of Cardio-Thoracic Surgery Expert Consensus Document appraises the available literature and synthesizes multidisciplinary expert knowledge to provide pragmatic, safety-oriented guidance for aeromedical examiners, treating clinicians, regulators, employers, and affected individuals. Focusing on civil aviation, it addresses return-to-duty considerations for professional aircrew and postoperative air-travel decisions for passengers. Key clinical and occupational determinants include procedure choice and durability, residual ischaemia or haemodynamic burden, arrhythmia risk, anticoagulation and device-related considerations, rehabilitation and surveillance testing, and, where appropriate, the role of operational restrictions such as multicrew limitations. Finally, it identifies key knowledge gaps and research priorities to support more consistent, evidence-based decision-making in this high-stakes setting.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":"41 10","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumour-to-Tumour Metastasis: A Rare Case of Clear Cell Renal Cell Carcinoma Metastasizing Into Lung Adenocarcinoma.","authors":"Valerio Sebastianelli, Silvia De Maria, Paolo Graziano, Marco Anile","doi":"10.1093/icvts/ivag201","DOIUrl":"10.1093/icvts/ivag201","url":null,"abstract":"<p><p>Tumour-to-tumour metastasis (TTM) is a very rare condition in which a malignant tumour (donor) metastasizes into another primary neoplasm, either benign or malignant (recipient). We report the case of a 74-year-old man previously surgically treated for a clear cell renal cell carcinoma (ccRCC) who developed a new subsolid nodule in the right upper pulmonary lobe discovered at a 4-year follow-up CT scan. The patient underwent a right uniportal thoracoscopic S1 segmentectomy and mediastinal lymph node dissection. Histopathological examination revealed a lung adenocarcinoma (LUAD) containing a focus of metastatic ccRCC without lymph node involvement or evidence of additional metastatic disease. To date, the patient remains disease-free. Metastasis of renal tumour cells into a primary lung tumour is exceptionally rare. To our knowledge, this is the first reported case of ccRCC metastasizing into LUAD without evidence of systemic dissemination.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable Machine Learning Using Accumulated Local Effects to Characterize Predictors of Subclinical Leaflet Thrombosis After Self-Expanding Transcatheter Aortic Valve Implantation.","authors":"Marco Moscarelli, Thanos Athanasiou, Roberto Casula, Vincenzo Pernice, Massimo Salardino, Gregorio Zaccone, Adriana Zlahoda-Huzior, Dariusz Dudek, Sabrina Milo, Giuseppe Speziale, Khalil Fattouch","doi":"10.1093/icvts/ivag144","DOIUrl":"10.1093/icvts/ivag144","url":null,"abstract":"<p><strong>Objectives: </strong>Subclinical leaflet thrombosis (SLT) is an early form of bioprosthetic valve dysfunction after transcatheter aortic valve implantation. Predicting SLT remains challenging. We aimed to apply machine learning not only to identify predictors but also to interpret their dynamic, non-linear effects on SLT risk using accumulated local effects (ALEs) curves, a robust method that accounts for variable collinearity.</p><p><strong>Methods: </strong>A prospective cohort of 128 consecutive patients receiving a self-expanding transcatheter heart valve underwent multimodality imaging and haematological profiling. The primary outcome was SLT on 6-month CT. An extreme gradient boosting classifier was trained on 126 variables. Model performance was evaluated via nested cross-validation. Interpretability used SHapley Additive exPlanations and ALEs plots.</p><p><strong>Results: </strong>Subclinical thrombosis was detected in 22 patients (17.1%). Extreme gradient boosting model demonstrated excellent discrimination (AUC: 0.91, 95% CI, 0.87-0.94) and calibration (Brier score: 0.09). SHapley Additive exPlanations analysis identified the top predictors: bicuspid valve anatomy (mean: 0.45), baseline haemoglobin (0.28), periprocedural Δhaematocrit (0.19), prosthesis eccentricity (0.14), and post-procedural platelet nadir (0.09). ALEs curves revealed a U-shaped association for baseline haemoglobin (lowest risk around 13 g/dL) a monotonic rise in SLT risk with increasing prosthesis eccentricity and greater periprocedural declines in haematocrit, and a progressively higher risk with post-procedural thrombocytopaenia.</p><p><strong>Conclusions: </strong>This study introduces ALEs plots to cardiovascular medicine, translating predictions into interpretable risk curves that show how leaflet thrombosis risk evolves across key predictors, linking valve geometry and periprocedural haematological changes to guide patient surveillance after transcatheter aortic valve replacement.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Bronchial Restapling After Inadvertent Stapling of an Endobronchial Suction Tube: Technical Note and a Prestapling Time-Out.","authors":"Sang Yun Song, Kyo Seon Lee, Kook Joo Na, Ju Sik Yun","doi":"10.1093/icvts/ivag261","DOIUrl":"10.1093/icvts/ivag261","url":null,"abstract":"<p><p>Foreign body entrapment during bronchial stapling is rare but may result in severe airway injury. We report an unusual intraoperative complication during robot-assisted thoracic surgery (RATS) lobectomy: inadvertent stapling of an endobronchial suction tube into the right lower lobe (RLL) bronchus, successfully managed robotically without conversion. A 65-year-old woman with clinical stage I lung adenocarcinoma underwent RATS RLL lobectomy with mediastinal lymph node dissection. During bronchial division, an endobronchial suction tube used to facilitate lung deflation was incorporated into the staple line. The tube was removed through limited resection of the involved bronchial stump segment, followed by traction-suture-assisted restapling. The postoperative course was uneventful, and 1-year follow-up showed no atelectasis and a patent right middle lobe bronchus with mild narrowing. When an adequate bronchial margin remains, robotic bronchial restapling may provide a feasible rescue option without conversion. A focused \"pre-stapling time-out\" to confirm the removal of endobronchial adjuncts may help prevent similar events.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiphospholipid syndrome and late pulmonary thrombosis after pulmonary endarterectomy.","authors":"Hengqiang Lin, Sheng Liu, Xinhe Xu, Hang Xu","doi":"10.1093/icvts/ivag269","DOIUrl":"https://doi.org/10.1093/icvts/ivag269","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of antiphospholipid syndrome in surgical chronic thromboembolic pulmonary hypertension and its association with late in situ pulmonary artery thrombosis after pulmonary endarterectomy.</p><p><strong>Methods: </strong>Retrospective cohort of 220 patients undergoing pulmonary endarterectomy at a single centre (2015-2024). Antiphospholipid syndrome was diagnosed per 2006 Sydney criteria with confirmatory antibody testing ≥12 weeks apart. The primary outcome was in situ pulmonary artery thrombosis on follow-up computed tomography pulmonary angiography. Survival and logistic regression analyses were performed.</p><p><strong>Results: </strong>Antiphospholipid syndrome was identified in 36 patients (16.4%), who were younger (40.2 vs 50.2 years; P=.001) and had more prior deep vein thrombosis (69.4% vs 48.9%; P=.038). Over a median 70.5-month follow-up, in situ pulmonary artery thrombosis was more frequent with antiphospholipid syndrome (36.1% vs 15.2%; relative risk 2.37; P=.008). Ten-year recurrence-free survival was 64% versus 82% (log-rank P=.002). Univariate odds ratio was 3.15 (95% confidence interval 1.43-6.94; P=.004); after adjustment for age, sex, and prior deep vein thrombosis, adjusted odds ratio was 2.22 (0.95-5.18; P=.064). Triple-positive patients (n = 6) had 83.3% in situ pulmonary artery thrombosis versus 26.7% in other antiphospholipid syndrome patients (P=.016; absolute risk difference 56.7 percentage points), a hypothesis-generating finding.</p><p><strong>Conclusions: </strong>Antiphospholipid syndrome is associated with elevated late in situ pulmonary artery thrombosis after pulmonary endarterectomy. The adjusted association was borderline. Triple positivity warrants validation in larger cohorts. Preoperative antibody testing may inform surveillance.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperations after failed aortic valve neocuspidization: Histopathological analysis of explanted leaflet material.","authors":"Igor Mokryk, Illia Nechai, Pavlo Snisarevskyi, Valentyna Zaritska, Galyna Prus, Fatemeh Hassanzadeh Ghasabeh, Borys Todurov","doi":"10.1093/icvts/ivag275","DOIUrl":"https://doi.org/10.1093/icvts/ivag275","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic valve neocuspidization (AVNeo) provides favorable mid-term outcomes, yet the histological mechanisms of valve failure requiring reoperation remain incompletely characterized. We performed histopathological and immunohistochemical analysis of explanted leaflet material from failed AVNeo valves to analyze their modes of failure at the histological level.</p><p><strong>Methods: </strong>Leaflet specimens explanted during reoperation for failed AVNeo between January 2021 and December 2025 underwent routine processing with hematoxylin and eosin staining. Additional staining for connective-tissue remodeling and calcification was performed according to local protocols. Immunohistochemistry included CD31 to assess endothelialization and vascular response, CD45 to characterize inflammatory infiltration, and vimentin to identify fibroblast-like mesenchymal cellular infiltration. Prespecified endpoints included inflammation, fibrin/fibrinopurulent deposition, degeneration, fibrosis, calcification, surface endothelialization, fibroblast-like infiltration, angiogenesis/angiomatosis, and restoration of fibrous architecture.</p><p><strong>Results: </strong>Specimens from six patients were analyzed. Indications for reoperation were IE in three patients, structural degeneration with aortic regurgitation in two GTAP valves, and leaflet perforation in one xenopericardial valve. Reoperation occurred earlier in IE cases than in non-IE cases. IE specimens showed severe inflammation, prominent fibrinous/fibrinopurulent surface deposits, absent CD31-positive surface endothelialization, absent fibroblast-like infiltration, and no vascular remodeling. In contrast, late non-IE GTAP specimens demonstrated partial surface endothelialization, fibroblast-like infiltration, mild angiogenesis/angiomatosis, fibrosis, mild calcification, and partial restoration of fibrous architecture. The xenopericardial specimen showed limited integration.</p><p><strong>Conclusions: </strong>Failed AVNeo leaflets demonstrate heterogeneous degeneration and time-dependent host integration. Late non-IE GTAP failures demonstrated histological evidence of tissue integration, including endothelialisation, cellular and vascular ingrowth, whereas early IE-related failures lack these features. Larger standardized studies are required.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative survival and oncologic characteristics of stage IA invasive mucinous adenocarcinoma.","authors":"Daisuke Ueda, Takahiro Mimae, Yujin Kudo, Takuya Nagashima, Yoshihiro Miyata, Hiroyuki Ito, Norihiko Ikeda, Morihito Okada","doi":"10.1093/icvts/ivag272","DOIUrl":"https://doi.org/10.1093/icvts/ivag272","url":null,"abstract":"<p><strong>Objectives: </strong>The prognosis of invasive mucinous adenocarcinoma has not been well investigated because of its rarity, especially with regard to early-stage disease. This study aimed to compare the prognosis of early-stage invasive mucinous adenocarcinoma with that of non-mucinous adenocarcinoma and to clarify oncologic characteristics of early-stage invasive mucinous adenocarcinoma.</p><p><strong>Methods: </strong>Patients with pathological stage IA lung adenocarcinoma, excluding pT1mi tumors, who underwent surgery at three institutions were retrospectively examined. Overall survival and recurrence-free survival were compared between patients with invasive mucinous adenocarcinoma and non-mucinous adenocarcinoma. Propensity score matching was applied to reduce baseline imbalances.</p><p><strong>Results: </strong>Among the 1228 patients, 1128 had non-mucinous adenocarcinoma and 100 had invasive mucinous adenocarcinoma. Before matching, invasive mucinous adenocarcinoma was significantly associated with smaller pathological whole tumor size, larger pathological invasive tumor size and a lower frequency of lymphovascular invasion. The 5-year overall survival rates were 92.5% and 92.7%, and the 5-year recurrence-free survival rates were 87.5% and 92.3% in patients with invasive mucinous and non-mucinous adenocarcinoma, respectively. Baseline covariates including pathological tumor size and stage were generally balanced after matching. The 5-year overall survival rates were 90.4% and 92.7%, and the 5-year recurrence-free survival rates were 83.7% and 93.3%, respectively, with no significant differences in survival curves between groups.</p><p><strong>Conclusions: </strong>The postoperative prognosis of patients with pathological stage IA invasive mucinous adenocarcinoma was comparable to that of patients with non-mucinous adenocarcinoma. These findings suggest that mucinous histology alone should not be considered an adverse prognostic factor in early-stage disease.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between preoperative EQ-5D visual analogue scale score and recurrence-free survival after lung cancer resection.","authors":"Hideo Ichimura, Keisuke Kobayashi, Masahiko Gosho, Kenji Minagi, Tomoyuki Kawamura, Shuntaro Kawabata, Hisashi Suzuki, Shinsuke Kitazawa, Naohiro Kobayashi, Yukinobu Goto, Yukio Sato","doi":"10.1093/icvts/ivag271","DOIUrl":"https://doi.org/10.1093/icvts/ivag271","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prognostic impact of preoperative self-reported global health status, assessed with the EQ-5D visual analogue scale (VAS), on recurrence-free survival (RFS) in patients undergoing resection for clinical stage I non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>This retrospective study included 200 patients from a single-center quality-of-life assessment cohort who underwent complete resection for clinical stage I NSCLC between January 2015 and April 2018. Preoperative QOL was assessed with the EQ-5D-5L. RFS was analyzed with the Kaplan-Meier method and the Cox proportional hazards model. Competing risk analysis was performed to distinguish recurrence from mortality due to other causes.</p><p><strong>Results: </strong>The median follow-up was 6.0 years and the 5-year RFS rate was 82.2% (42 events). On univariable Cox analysis for RFS, the hazard ratio (HR) per 1-unit decrease in EQ-5D VAS scores was 1.020(95% CI 1.002-1.039). An EQ-5D VAS score ≤55 was also associated with worse RFS (HR 2.762, 95% CI 1.271-6.005; p = 0.010). On competing risk analysis adjusting for Performance Status, and modified Glasgow Prognostic Score, the recurrence risk of lung cancer was significantly higher in the VAS ≤55 group (adjusted HR 3.45, 95% CI 1.09-10.96), whereas mortality from other causes was comparable between the 2 VAS groups.</p><p><strong>Conclusions: </strong>Lower preoperative EQ-5D VAS scores were associated with poorer recurrence-free survival in patients with clinical stage I NSCLC, driven primarily by increased recurrence rather than by other-cause mortality.</p>","PeriodicalId":73406,"journal":{"name":"Interdisciplinary cardiovascular and thoracic surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}