Prognostic impact of the N2 subclassification and stage migration in the ninth edition of the TNM classification in surgically resected lung cancer.

Objectives: In the ninth edition of the TNM classification of lung cancer, N2 is subdivided into single-station (N2a) and multiple-station involvement (N2b), and some stage changes are made to stage II-III. This study aimed to validate the new classification and determine the effect of stage migration and vice versa on the prognosis of each pathological stage due to these changes.

Materials And Methods: A total of 1,754 patients with surgically resected lung cancer were included.

A prospective study of a training program for bronchial sleeve resection using operable 3-dimensional models.

Objective: To develop a training program for bronchial sleeve reconstruction using our previously developed 3-dimensional (3D) operable airway model and evaluate its effectiveness in surgical trainees.

Methods: Eight trainees and 4 faculty surgeons were enrolled. Their right upper lobe sleeve reconstruction procedures were scored by 2 senior surgeons in a blinded fashion on a 5-point Likert scale on the following: airway wall tear, reapplied ligatures, reapplied needles, needle entry and exit, anastomotic bite, and caliber adjustment (full score: 30).

Impact of tumor location and pleural invasion on the frequency of skip hilar lymph node metastasis in lung cancer.

Background: The appropriate extent of hilar lymph node (LN) dissection in segmentectomy for lung cancer has not yet been fully investigated. Herein, we assessed the patterns of LN metastasis using network analyses.

Methods: Patients with nodal metastases of non-small-cell lung cancer measuring ≤30 mm in diameter who underwent anatomical resection were included.

Risk of Death From Other Diseases in Lung Cancer Patients After Sublobar Resection Versus Lobectomy.

Background And Objectives: A recent Japanese phase three clinical trial for lung cancer suggested a possible advantage of segmentectomy over lobectomy in terms of death from other diseases. This study aimed to compare the risk of death from other diseases based on surgical procedures in lung cancer patients without recurrence.

Methods: We retrospectively reviewed 2121 patients without disease recurrence after curative resection for lung cancer at our institution.

Accuracy of thoracic nerves recognition for surgical support system using artificial intelligence.

We developed a surgical support system that visualises important microanatomies using artificial intelligence (AI). This study evaluated its accuracy in recognising the thoracic nerves during lung cancer surgery. Recognition models were created with deep learning using images precisely annotated for nerves.

Utility of visualization and quantification of surgical techniques using motion analysis software for thoracoscopic surgery.

In this era of endoscopic surgery, feedback from recorded surgical videos is useful and efficient; therefore, effective methods of obtaining this feedback are needed. We analyzed surgical videos using motion analysis software and verified the usefulness of visualizing and objectively evaluating surgical procedures. We measured the grasping and traction angles of the vascular sheath when using forceps and the trajectory of the forceps tip for the upper pulmonary vein during right upper lobectomy during video-assisted thoracoscopic surgery performed by three trainers and trainees.

Prognostic impact of ground-glass opacity components in lung cancer with lymph node metastasis.

Background: In early-stage non-small cell lung cancer (NSCLC), the presence of a ground-glass opacity (GGO) component in the primary lesion on high-resolution computed tomography (CT) is recognized as a favorable prognostic factor. Even in NSCLC with a GGO component, lymph node metastases are occasionally detected during or after surgery. However, the prognostic impact of GGO components in these patients has not been clarified.

Optimal Treatment Strategy for Oligo-Recurrence Lung Cancer Patients with Driver Mutations.

Background: The efficacy of local therapies for lung cancer patients with postoperative oligo-recurrence has been reported. However, whether local therapies should be chosen over molecular targeted therapies for oligo-recurrence patients with driver mutations remains controversial. Therefore, we aimed to investigate the optimal initial treatment strategy for oligo-recurrence in lung cancer patients with driver mutations.

Prediction of Tumor PD-L1 Expression in Resectable Non-Small Cell Lung Cancer by Machine Learning Models Based on Clinical and Radiological Features: Performance Comparison With Preoperative Biopsy.

Objective: We investigated if PD-L1 expression can be predicted by machine learning using clinical and imaging features.

Methods: We included 117 patients with c-stage I/II non-small cell lung cancer who underwent radical resection. A total of 3951 radiomic features were extracted by defining the tumor (within tumor contour), rim (contour ±3 mm) and exterior (contour +10 mm) on preoperative contrast computed tomography.

Outcomes of lung oligometastasis in pancreatic cancer.

Objective: Pancreatic cancer with lung oligometastasis may have favourable overall survival. The aim of this study was to evaluate outcomes of pancreatic cancer with lung oligometastases including both synchronous and metachronous metastases.

Methods: Consecutive pancreatic cancer patients with lung metastasis treated at our institution between February 2015 and December 2021 were identified from our prospectively maintained database.

Prognostication Using the Japanese Risk Calculator for Lung Cancer Surgery.

Introduction: Various calculation models to predict surgical risk have been developed globally. These have been reported to be helpful for estimating the long-term prognosis. In Japan, a similar model for lung cancer surgery was developed in 2017; however, there have been no reports investigating its association with the long-term prognosis.

Risk factors for bronchopleural fistula after lobectomy for lung cancer.

Background: Bronchopleural fistula (BPF) after lobectomy for lung cancer is a rare but serious complication. This study aimed to stratify the risk factors of BPF.

Methods: Patients who underwent lobectomy without bronchoplasty and preoperative treatment for lung cancer between 2005 and 2020 were retrospectively reviewed.

Detection of mutations in early-stage lung adenocarcinoma by machine learning-based radiomics.

Background: We hypothesized that epidermal growth factor receptor () mutations could be detected in early-stage lung adenocarcinoma using radiomics.

Methods: This retrospective study included consecutive patients with clinical stage I/II lung adenocarcinoma who underwent curative-intent pulmonary resection from March-December 2016. Using preoperative enhanced chest computed tomography, 3,951 radiomic features were extracted in total from the tumor (area within the tumor boundary), tumor rim (area within ±3 mm of the tumor boundary), and tumor exterior (area between +10 mm outside the tumor and tumor boundary).

How to Perform and Prepare for Robotic Sleeve Lobectomy.

Compared with video-assisted thoracic surgery, robotic surgery may be particularly useful for reconstructive procedures such as sleeve lobectomy. However, specific training for robot-specific tricks and pitfalls is warranted. Using running suture with a short double-armed suture, we have demonstrated the feasibility of simulating robotic sleeve resection with a previously developed 3-dimensional operable airway model.

Initial perioperative outcomes of robot-assisted thoracoscopic lobectomy using a confronting setting.

Purpose: Most robot-assisted thoracoscopic surgery (RATS) is performed from the vertical view. This study evaluates the initial outcomes of our novel confronting RATS technique, in which the patient was viewed horizontally, as in open thoracotomy.

Methods: We reviewed data on patients who underwent thoracoscopic lobectomy between January, 2019 and April, 2022.

Distinct Prognostic Impact of PET Findings Based on Radiological Appearance in Clinical Stage IA Lung Adenocarcinoma.

Introduction: Although solid appearance on computed tomography and positive findings on positron emission tomography (PET) have been both associated with poor outcome in lung adenocarcinoma, the extent to which these findings overlap is unknown. This study aimed to determine the differences in prognostic significance of PET findings in part-solid nodules (PSNs) and solid nodules.

Materials And Methods: We retrospectively investigated 417 patients with clinical stage IA adenocarcinoma who underwent curative resection between 2010 and 2017.

Impact of previous upper gastrointestinal cancer surgery on complications after lobectomy for lung cancer.

Background: The number of lung cancer patients with a history of other malignancies is increasing. Previous upper gastrointestinal cancer (UGIC) surgery may increase the risk of complications after lung cancer surgery due to malnutrition and susceptibility in patients; therefore, we investigated its short-term outcomes.

Methods: We retrospectively examined patients with lung cancer who underwent thoracoscopic lobectomy between 2011 and 2021 and collected data regarding postoperative complications and postoperative pulmonary complications ≥ grade II of the Clavien-Dindo classification that developed within 3 months post-surgery.