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2025年肺癌外科领域重要进展
Important progress in surgical treatment of lung cancer in 2025
- 中国癌症杂志 2026年
- 作者机构：
1.复旦大学附属肿瘤医院胸外科与基因工程重点实验室
2.复旦大学胸部肿瘤研究所
3.复旦大学上海医学院肿瘤学系
- 作者简介：
张扬，复旦大学附属肿瘤医院胸外科，中华人民共和国，上海市，东安路270号，复旦大学附属肿瘤医院胸外科，邮编200032，邮箱：fduzhangyang1987@hotmail.com.
陈海泉，复旦大学附属肿瘤医院胸外科，中华人民共和国，上海市，东安路270号，复旦大学附属肿瘤医院胸外科，邮编200032，邮箱：hqchen1@yahoo.com;
- 基金信息：国家自然科学基金(81930073);上海市技术创新行动计划(20JC1417200);徐汇区重大疾病防治合作项目(XHLHG202101);国家重点研发计划(2022YFA103900)
DOI：
中图分类号：收稿：2026-01-04，
- 稿件说明：
移动端阅览
曹航, 张扬, 陈海泉. 2025年肺癌外科领域重要进展[J/OL]. 中国癌症杂志, 2026.
Hang Cao, MD, Yang Zhang. Important progress in surgical treatment of lung cancer in 2025[J/OL]. Chin Oncol, 2026.
摘要
肺癌是中国发病率和死亡率最高的恶性肿瘤，外科手术是肺癌治疗的重要手段。2025年，肺癌外科治疗领域取得了多项重要进展。ECTOP-1021研究证实，对惰性多发性磨玻璃结节在“外科治愈窗口期”内进行主动监测安全可行，并提出基于肺功能损失评估的分层管理策略。ECTOP-1009研究首次通过Ⅲ期随机对照试验为磨玻璃成分为主型肺癌不进行纵隔淋巴结清扫提供了高级别循证依据，实现从“系统性清扫”到“选择性豁免”的范式转变。JCOG0802研究的10年随访结果显示肺段切除术不劣于肺叶切除，但局部复发率高于肺叶切除术，提示应严格把握手术指征并确保足够切缘。ECTOP-1011研究通过病理大切片技术揭示影像与病理的不完全对应，为术前精准评估提供新依据。此外，“外科治愈窗口期”量化模型的建立与部位特异性随访策略的提出，推动术后管理迈向个体化与精准化。多组学研究进一步从分子层面阐释肺腺癌演进规律，为早期干预与预后预测奠定科学基础。本文系统回顾2025年肺癌外科领域关键进展，以期为临床实践与研究提供参考。
Abstract
Lung cancer is the malignancy with the highest incidence and mortality in China
and surgical resection remains a cornerstone of its treatment. In 2025
significant progress has been made in the field of lung cancer surgery. The ECTOP-1021 trial demonstrated the safety and feasibility of active surveillance for indolent multifocal ground-glass opacities within the "surgical curative window
" proposing a risk-stratified management framework based on predicted pulmonary function loss. The phase III randomized ECTOP-1009 study provided high-level evidence for omitting mediastinal lymph node dissection in ground-glass opacity-dominant lung adenocarcinoma
marking a paradigm shift from "systematic dissection" to "selective omission." The 10-year follow-up results of the JCOG0802 trial showed that segmentectomy was not inferior to lobectomy
but the local recurrence rate was higher than lobectomy
emphasizing the importance of strict patient selection and adequate surgical margins. The ECTOP-1011 study
utilizing whole-mount pathological sections
revealed discrepancies between radiological and pathological findings
offering new insights for precise preoperative assessment. Furthermore
the establishment of a quantifiable "surgical curative window" model and the development of a site-specific follow-up strategy have advanced postoperative management toward personalization and precision. Multi-omics research has elucidated the molecular evolutionary trajectory of lung adenocarcinoma
providing a scientific basis for early intervention and prognosis prediction. This article reviews key advances in lung cancer surgery in 2025 to inform clinical practice and future research.
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references
WANG J , CAO H , HE N , et al . Evolving Trends in Surgically Managed Lung Cancer: A 16-Year Hospital-Based Epidemiological Analysis [J ] . Lung Cancer , 2025 , 208 : 108754 .
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ALTORKI N , DAMMAN B , WANG X , et al . The extent of lymph node dissection is not associated with disease-free survival following lobar or sublobar resection: Results from Cancer and Leukemia Group B 140503 (Alliance) [J ] . J Thorac Cardiovasc Surg , 2025 , 170 ( 4 ): 933 - 42 e2 .
LI T , ZHANG Y , HU H , et al . Defining the surgical curative time window: identifying patients with an absence of recurrence for 5 years following surgical resection of stage I invasive non-small cell lung cancer [J ] . Transl Lung Cancer Res , 2025 , 14 ( 11 ): 4719 - 32 .
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FU F , SHANG J , YAN Y , et al . Genomic and transcriptomic dynamics in the stepwise progression of lung adenocarcinoma [J ] . Cell Res , 2025 .
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