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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Methodology, Drug and Device Discovery".

Deadline for manuscript submissions: closed (25 November 2023) | Viewed by 6685

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Special Issue Editors

Dr. Antonio Mazzella

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Guest Editor

Division of Thoracic Oncology, European Institute of Oncology (IEO), Milano, Italy
Interests: minimally invasive thoracic surgery; robotic surgery; thoracic surgery; thoracic oncology; lung cancer; thoracic neoplasms

Prof. Dr. Stéphane Renaud

E-Mail Website
Guest Editor

Department of Thoracic Surgery, Nancy Regional University Hospital, 5, allée du Morvan, 54500 Vandoeuvre-lès-Nancy, France
Interests: minimally invasive thoracic surgery; robotic surgery; navigation bronchoscopy; thoracic oncology; lung cancer; thoracic neoplasms

Special Issue Information

Dear Colleagues,

Background: In the last 15 years, we witnessed significant progress in the field of thoracic surgery and oncology.

Aim and scope: We aim to publish articles describing innovative approaches in the treatment of lung cancer, such as minimally invasive and robotic surgery, electromagnetic navigation bronchoscopy, 3D techniques or medical innovative treatments.

History: With the advent of new technologies, methods and treatments, we witnessed important improvements in immediate post-operative clinical conditions of the patients undergoing lung surgery and, more generally, improvements in the middle and long-term prognosis of these patients.

Cutting-edge research: The advantages of minimally invasive surgery, endobronchial diagnosis or target therapy and immunotherapy in the treatment of advanced lung cancer have been investigated for the management of lung cancer.

What kind of paper we are looking for: We encourage the submission of manuscripts that describe an innovative approach in the treatment of lung cancer, both surgical and medical.

Dr. Antonio Mazzella
Prof. Dr. Stéphane Renaud
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

lung cancer
minimally invasive surgery
robotic surgery
innovative approaches
navigation bronchoscopy
innovative medical treatments
future perspectives

Published Papers (5 papers)

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Research

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14 pages, 1874 KiB

Open AccessArticle

Recurrence-Free Survival in Early and Locally Advanced Large Cell Neuroendocrine Carcinoma of the Lung after Complete Tumor Resection

Bertrand Richard de Latour

and

J. Pers. Med. 2023, 13(2), 330; https://doi.org/10.3390/jpm13020330 - 15 Feb 2023

Viewed by 1150

Abstract

Background: Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in this subgroup of patients and to identify potential prognostic markers. Methods: Retrospective multicenter study including patients with pure LCNEC stage I-III and R0 resection. Clinicopathological characteristics, RFS, and disease-specific survival (DSS) were evaluated. Univariate and multivariate analyses were performed. Results: 39 patients (M:F = 26:13), with a median age of 64 years (44–83), were included. Lobectomy (69.2%), bilobectomy (5.1%), pneumonectomy (18%), and wedge resection (7.7%) were performed mostly associated with lymphadenectomy. Adjuvant therapy included platinum-based chemotherapy and/or radiotherapy in 58.9% of cases. After a median follow-up of 44 (4–169) months, the median RFS was 39 months with 1-, 2- and 5-year RFS rates of 60.0%, 54.6%, and 44.9%, respectively. Median DSS was 72 months with a 1-, 2- and 5-year rate of 86.8, 75.9, and 57.4%, respectively. At multivariate analysis, age (cut-off 65 years old) and pN status were independent prognostic factors for both RFS (HR = 4.19, 95%CI = 1.46–12.07, p = 0.008 and HR = 13.56, 95%CI 2.45–74.89, p = 0.003, respectively) and DSS (HR = 9.30, 95%CI 2.23–38.83, p = 0.002 and HR = 11.88, 95%CI 2.28–61.84, p = 0.003, respectively). Conclusion: After R0 resection of LCNEC, half of the patients recurred mostly within the first two years of follow-up. Age and lymph node metastasis could help to stratify patients for adjuvant therapy. Full article

(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)

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13 pages, 1884 KiB

Open AccessArticle

Learning Curve of Robotic Lobectomy for the Treatment of Lung Cancer: How Does It Impact on the Autonomic Nervous System of the Surgeon?

and

J. Pers. Med. 2023, 13(2), 193; https://doi.org/10.3390/jpm13020193 - 21 Jan 2023

Cited by 1 | Viewed by 1306

Abstract

Objective: Our purpose is to define the learning curve for robot-assisted thoracoscopic surgery lobectomy by reporting the experience of a single surgeon. Material and methods: We progressively collected the data concerning the surgical performance of a single male thoracic surgeon, from the beginning of his robotic activity as first operator from January 2021 to June 2022. We evaluated several pre-, intra- and postoperative parameters concerning patients and intraoperative cardiovascular and respiratory outcomes of the surgeon, recorded during surgical interventions, in order to evaluate his cardiovascular stress. We used cumulative sum control charts (CUSUM) to analyze the learning curve. Results: A total of 72 lung lobectomies were performed by a single surgeon in this period. Analyzing the CUSUM of several parameters, the inflection point identifying the transition beyond the surgeon learning phase was reached at cases 28, 22, 27 and 33 when considering operating time, mean heart rate, max heart rate and mean respiratory rate, respectively. Conclusions: The learning curve for robotic lobectomy seems to be safe and feasible with a correct robotic training program. The analysis of a single surgeon from the beginning of his robotic activity demonstrates that confidence, competence, dexterity and security are achieved after about 20–30 procedures, without compromising efficiency and oncological radicality. Full article

(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)

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12 pages, 899 KiB

Open AccessArticle

Sentinel Lymph Node in Non-Small Cell Lung Cancer: Assessment of Feasibility and Safety by Near-Infrared Fluorescence Imaging and Clinical Consequences

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J. Pers. Med. 2023, 13(1), 90; https://doi.org/10.3390/jpm13010090 - 30 Dec 2022

Cited by 2 | Viewed by 1406

Abstract

Occult micrometastases can be missed by routine pathological analysis. Mapping of the pulmonary lymphatic system by near-infrared (NIR) fluorescence imaging can identify the first lymph node relay. This sentinel lymph node (SLN) can be analyzed by immunohistochemistry (IHC), which may increase micrometastasis detection and improve staging. This study analyzed the feasibility and safety of identifying SLNs in thoracic surgery by NIR fluorescence imaging in non-small cell lung cancer (NSCLC). This was a prospective, observational, single-center study. Eighty adult patients with suspected localized stage NSCLC (IA1 to IIA) were included between December 2020 and May 2022. All patients received an intraoperative injection of indocyanine green (ICG) directly in the peri tumoural area or by electromagnetic navigational bronchoscopy (ENB). The SLN was then assessed using an infrared fluorescence camera. SLN was identified in 60 patients (75%). Among them, 36 SLNs associated with a primary lung tumor were analyzed by IHC. Four of them were invaded by micrometastases (11.1%). In the case of pN0 SLN, the rest of the lymphadenectomy was cancer free. The identification of SLNs in thoracic surgery by NIR fluorescence imaging seems to be a feasible technique for improving pathological staging. Full article

(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)

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Review

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11 pages, 1198 KiB

Open AccessReview

Surgical Approaches to Pancoast Tumors

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J. Pers. Med. 2023, 13(7), 1168; https://doi.org/10.3390/jpm13071168 - 21 Jul 2023

Cited by 1 | Viewed by 1184

Abstract

Pancoast tumors, also defined as superior sulcus tumors, still represent a complex clinical condition requiring high technical surgical skills within more articulated multimodality treatment. The morbidity and mortality rates after Pancoast tumor treatments range from 10 to 55% and 0 to 7%, respectively, and the 5-year survival rate has significantly improved in recent years thanks to the advancement of treatments. Although a multimodality approach combining chemotherapy, radiotherapy, and surgery allows for radical resection and effective local control in the vast majority of patients, many patients cannot receive surgical resection or complete the whole programmed therapeutic regimen. Systemic relapse, particularly cerebral recurrence, still poses a significant issue in this cohort of patients. Surgical resection still plays a pivotal role within the multimodality approach. Here, we focus on surgical approaches to both anterior and posterior Pancoast tumors: the anterior transclavicular approach (Dartevelle); the anterior transmanubrial approach (Grunenwald–Spaggiari); the anterior trap-door approach (Masaoka, Nomori); the posterior approach (Shaw–Paulson); the hemiclamshell approach; and hybrid approaches. Global clinical condition, tumor histology, and long-term perspectives should always be taken into consideration when embarking on such a demanding oncologic scenario. Full article

(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)

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Other

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7 pages, 211 KiB

Open AccessOpinion

A Practical Assessment of the Postoperative Management in Lung Cancer Surgery

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J. Pers. Med. 2023, 13(2), 358; https://doi.org/10.3390/jpm13020358 - 18 Feb 2023

Viewed by 1072

Abstract

Postoperative management after major and minor thoracic surgeries is crucial for patient recovery and can be challenging. Major thoracic surgeries, such as extensive pulmonary resections, especially in patients with poor health status, may require intensive surveillance, particularly during the first 24–72 h after surgery. Moreover, thanks to the demographic development and medical progress in perioperative medicine, more patients with comorbidities undergoing thoracic procedures require proper management in the postoperative period to improve prognosis and decrease hospital stay. Here, we summarize the main thoracic postoperative complications in order to clarify how to prevent them through a series of standardized procedures. Full article

(This article belongs to the Special Issue Innovative Approaches in Lung Cancer Treatment)

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