Lin Huang

Objectives: Pulmonary metastasectomy is not a standardised procedure, with no consensus regarding the optimal extent of lung resection. This international multicentre study aimed at comparing short and long-term outcomes of anatomical versus non-anatomical pulmonary metastasectomy. Methods: Retrospective database including 1647 patients aged ≥18 years, who underwent curative intent pulmonary metastasectomy between January 2010 and December 2018 at 15 European centres. Patients who underwent pneumonectomy, previous metastasectomies, and/or suffered from extrapulmonary recurrence at the time of lung surgery were excluded. Primary endpoint was overall survival. Secondary endpoints were recurrence-free survival and 30-day morbidity. Differences between the two groups were analysed using 3:1 matching. Results: In the matched cohort, 324 patients underwent anatomical resection, and 830 patients underwent non-anatomical resection. Five-year overall survival was 62.0%. Averaged over the entire follow-up, there was no significant difference in overall survival between the two groups (HR = 1.122, 95% CI = 0.909–1.385, p = 0.283). In the early period following pulmonary metastasectomy, anatomical resections were associated with worse overall survival (HR = 1.549, 95% CI = 1.135–2.114, p = 0.006). The difference in any-site recurrence-free survival between the two groups was not significant (HR = 0.832, 95% CI = 0.690–1.002, p = 0.053). Locoregional recurrence-free survival was significantly longer after anatomical resection (HR = 0.651, 95% CI = 0.520–0.817, p < 0.001). Thirty-day morbidity was significantly higher after anatomical resection (22.2% versus 13.7% for non-anatomical resections, p = 0.001). Conclusions: In a highly selected cohort, non-anatomical resection showed comparable survival and lower morbidity compared to anatomical resections, supporting the surgical strategy of favouring limited resections whenever technically and oncologically feasible. Anatomical resections remain a valid option in selected cases with acceptable outcomes.

The purpose of this study was to compare patient-reported outcomes (PROs) and perioperative clinical outcomes during 1 year post surgery between robot-assi

Objectives: This study aims to investigate the first 90 days alive and out of hospital (DAOH90) following enhanced recovery thoracoscopic segmentectomy versus lobectomy. Methods: A retrospective analysis for consecutive thoracoscopic segmentectomies and lobectomies for clinical stage IA1-2 non-small cell lung cancer (cIA1-2 NSCLC) was performed between January 2018 and March 2024. All factors contributing to reduced DAOH90 were analyzed individually. The association between surgical extent and DAOH90 was assessed using a multivariable logistic regression model. Sensitivity analyses were performed after propensity score matching. Results: Of 720 patients, 591 underwent lobectomy and 129 underwent segmentectomy. Compared with lobectomy, patients undergoing segmentectomy had poorer lung function and exercise capacity, more comorbidities, slightly longer operative duration, and less blood loss. The median DAOH90 was 1 day longer after segmentectomy than lobectomy (87 vs 86 days, P = .049). Air leak > 1 day (38.3% vs 40.0%), pneumonia (13.3% vs 18.3%), and pain (13.3% vs 23.3%) were important reasons to reduce DAOH90, all occurring more frequently in the lobectomy group. Social factors (37.5% vs 25.8%) were also a predominant cause in both groups, particularly after segmentectomy. Other causes were less common. In multivariable analysis, lobectomy (vs segmentectomy, OR 1.44, P = .048) was identified as an independent predictor of shorter DAOH90, along with body mass index, lung function, and cardiac comorbidity. The results of the sensitivity analysis were consistent with these findings. Conclusions: Following an enhanced recovery thoracoscopic protocol, segmentectomy for well-selected patients with cIA1-2 NSCLC may result in longer DAOH and less postoperative complications compared to lobectomy.

Introduction and aim Despite global advances in lung cancer treatment, challenges persist in symptom management and supportive care, particularly as the incidence of early-stage diagnoses rises. Patients with non-small cell lung cancer (NSCLC) face symptom burdens compounded by physical, psychological and social factors, alongside the concealment of early-stage symptoms. Research on symptom management in patients with NSCLC remains limited, with a lack of studies exploring patient experiences and clinical management strategies. Moreover, attention to late effects highlights the need for personalised care interventions to address long-term outcomes. The SCAPAS-LungCancer study aims to bridge these gaps by enhancing our understanding of NSCLC symptomatology, late effects and quality of life. The study seeks to identify patients with multiple symptoms and late effects, offering insights for future personalised care interventions to improve patient outcomes and overall well-being. Methods and analysis The study employs a multiple-methods approach encompassing qualitative and quantitative investigations to comprehensively explore symptomatology, patient experiences and treatment outcomes in patients with NSCLC undergoing surgical treatment. A prospective, longitudinal, observational and exploratory design is adopted. A longitudinal qualitative study, including individual interviews and ethnographic fieldwork, will be conducted to explore patients’ experiences and interactions with clinicians on symptoms and late effects. Additionally, consecutive newly diagnosed patients with NSCLC scheduled for surgery will be recruited in a prospective questionnaire study using patient-reported outcomes. Eligible patients will complete self-reported measures assessing physical and psychosocial symptom burden and late effects, quality of life, social support and unmet needs at baseline and multiple follow-up points post-surgery over a 2-year period. Socio-demographic and medical characteristics are also collected. Ethics and dissemination The study is approved by the Danish Data Protection Agency (journal no: 2022-737) and conducted in accordance with Danish Ethics Research Committee guidelines and the Helsinki II Declaration. Participants will provide written informed consent. The results will be reported in peer-reviewed journals.