Important progress in surgical treatment of lung cancer in 2023

Bin QIAN; Haiquan CHEN

doi:10.19401/j.cnki.1007-3639.2024.04.001

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Important progress in surgical treatment of lung cancer in 2023

Specialist' Commentary | 更新时间：2025-12-31

- Important progress in surgical treatment of lung cancer in 2023
- China Oncology Vol. 34, Issue 4, Pages: 335-339(2024)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院胸外科，复旦大学上海医学院肿瘤学系，上海 200032
  2. 扬州市江都人民医院胸外科，江苏扬州 225000
  3. 复旦大学胸部肿瘤研究所，上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2024.04.001
  CLC： R734.2
- Received：28 March 2024，
  
  Revised：2024-04-28，
  
  Published：30 April 2024
- 稿件说明：
移动端阅览
Bin QIAN, Haiquan CHEN. Important progress in surgical treatment of lung cancer in 2023[J]. China Oncology, 2024, 34(4): 335-339.
DOI：

Bin QIAN, Haiquan CHEN. Important progress in surgical treatment of lung cancer in 2023[J]. China Oncology, 2024, 34(4): 335-339. DOI： 10.19401/j.cnki.1007-3639.2024.04.001.

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。2023年，肺癌外科治疗领域取得了多项重要进展。首先是CALGB140503研究结果公布，该研究表明，对于周围型≤2 cm小结节肺癌，亚肺叶切除与肺叶切除术在生存率上差异无统计学意义，为确立亚肺叶切除术在早期肺癌治疗中的地位奠定了基础。其次，JCOG1211研究发现肺段切除术可以用于治疗2 ~ 3 cm磨玻璃结节为主的肺腺癌，但是该研究存在过度治疗现象，通过术中快速冷冻切片病理学检查可能降低过度治疗的风险。ECTOP-1003研究提出了基于肿瘤部位和术中快速冷冻切片病理学检查的选择性淋巴结清扫策略，准确率达100%，为淋巴结清扫提供了更加精准的方案。此外，对于肺腺癌治愈窗口期的探索成果也引人瞩目，即在早期肺癌治疗中，需要把握手术治愈的时间窗，避免过度治疗。最后，ECTOP-1008研究结果显示，高分辨率胸部CT有助于判断肺癌的病理浸润程度，有助于治愈窗口期的精准判断。本文对2023年度肺癌外科治疗领域的重要研究进展予以回顾，以期为肺癌外科治疗的临床实践及未来的临床研究提供思路。

Abstract

Lung cancer is the malignant tumor with the highest incidence and mortality rate in China

and surgical resection is a crucial approach for its treatment. In 2023

significant advancements were made in the field of lung cancer surgery. Firstly

CALGB140503 showed that for peripheral ≤2 cm nodular lung cancer

sublobar resection demonstrated no significant difference in survival rates compared to lobectomy

establishing the foundation for its role in early lung cancer treatment. Secondly

JCOG1211 found that segmentectomy could be used to treat 2-3 cm ground-glass opacity-predominant adenocarcinoma

however

patient in this study may undergo overtreatment

which could potentially be mitigated through intraoperative rapid frozen section pathological examination. Furthermore

the ECTOP-1003 study proposed a selective lymph node dissection strategy based on tumor location and intraoperative rapid frozen section pathological examination

achieving a 100% accuracy rate and providing a more precise approach to lymph node dissection. Additionally

the exploration of the cure time window for lung adenocarcinoma was remarkable

emphasizing the importance of timing in surgical intervention to avoid overtreatment in early lung cancer treatment. Finally

the ECTOP-1008 study demonstrated that high-resolution chest computed tomography (CT) scans assisted in determining the pathological invasion degree of lung cancer

aiding in the precise judgment of curative time window. This review summarized the important research progress in the field of lung cancer surgery in 2023

aiming to provide insights for clinical practice and future trials in lung cancer surgery.

关键词

Keywords

references

郑荣寿 , 张思维 , 孙可欣 , 等 . 2016年中国恶性肿瘤流行情况分析 [J ] . 中华肿瘤杂志 , 2023 , 45 ( 3 ): 212 - 220 .

ZHENG R S , ZHANG S W , SUN K X , et al . Cancer statistics in China, 2016 [J ] . Chin J Oncol , 2023 , 45 ( 3 ): 212 - 220 .

ALTORKI N , WANG X F , KOZONO D , et al . Lobar or sublobar resection for peripheral stage ⅠA non-small cell lung cancer [J ] . N Engl J Med , 2023 , 388 ( 6 ): 489 - 498 .

RUSCH VALERIE W . Initiating the era of “precision” lung cancer surgery [J ] . N Engl J Med , 2023 , 388 ( 6 ): 557 - 558 .

ALTORKI N , WANG X F , DAMMAN B , et al . Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: a post hoc analysis of CALGB 140503 (Alliance) [J ] . J Thorac Cardiovasc Surg , 2024 , 167 ( 1 ): 338 - 347.e1 .

SAJI H , OKADA M , TSUBOI M , et al . Segmentectomy versus lobectomy in small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial [J ] . Lancet , 2022 , 399 ( 10335 ): 1607 - 1617 .

AOKAGE K , SUZUKI K , SAJI H , et al . Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): a multicentre, single-arm, confirmatory, phase 3 trial [J ] . Lancet Respir Med , 2023 , 11 ( 6 ): 540 - 549 .

LI D , DENG C Q , WANG S P , et al . Ten-year follow-up of lung cancer patients with resected adenocarcinoma in situ or minimally invasive adenocarcinoma: wedge resection is curative [J ] . J Thorac Cardiovasc Surg , 2022 , 164 ( 6 ): 1614 - 1622 .e1.

LIU S , WANG R , ZHANG Y , et al . Precise diagnosis of intraoperative frozen section is an effective method to guide resection strategy for peripheral small-sized lung adenocarcinoma [J ] . J Clin Oncol , 2016 , 34 ( 4 ): 307 - 313 . DOI: 10.1200/JCO.2015.63.4907 http://doi.org/10.1200/JCO.2015.63.4907

ZHANG Y , DENG C Q , FU F Q , et al . Excellent prognosis of patients with invasive lung adenocarcinomas during surgery misdiagnosed as atypical adenomatous hyperplasia, adenocarcinoma in situ , or minimally invasive adenocarcinoma by frozen section [J ] . Chest , 2021 , 159 ( 3 ): 1265 - 1272 .

ZHANG Y , DENG C Q , ZHENG Q , et al . Selective mediastinal lymph node dissection strategy for clinical T1N0 invasive lung cancer: a prospective, multicenter, clinical trial [J ] . J Thorac Oncol , 2023 , 18 ( 7 ): 931 - 939 . DOI: 10.1016/j.jtho.2023.02.010 http://doi.org/10.1016/j.jtho.2023.02.010

KWAN K H . Selective mediastinal lymph node dissection: precision surgery in the era of precision medicine [J ] . J Thorac Oncol Off Publ Int Assoc Study Lung Cancer , 2023 , 18 ( 7 ): 834 - 837 .

LI D , DENG C Q , WANG S P , et al . Ten-year follow-up results of pure ground-glass opacity-featured lung adenocarcinomas after surgery [J ] . Ann Thorac Surg , 2023 , 116 ( 2 ): 230 - 237 . DOI: 10.1016/j.athoracsur.2023.01.014 http://doi.org/10.1016/j.athoracsur.2023.01.014

YOTSUKURA M , ASAMURA H , MOTOI N , et al . Long-term prognosis of patients with resected adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung [J ] . J Thorac Oncol , 2021 , 16 ( 8 ): 1312 - 1320 .

FU F Q , CHEN Z W , CHEN H Q . Treating lung cancer: defining surgical curative time window [J ] . Cell Res , 2023 , 33 ( 9 ): 649 - 650 .

CHENG X H , ONAITIS M W , et al . Minimally invasive thoracic surgery 3.0: lessons learned from the history of lung cancer surgery [J ] . Ann Surg , 2018 , 267 ( 1 ): 37 - 38 . DOI: 10.1097/SLA.0000000000002405 http://doi.org/10.1097/SLA.0000000000002405

YE T , WU H X , WANG S P , et al . Radiologic identification of pathologic tumor invasion in patients with lung adenocarcinoma [J ] . JAMA Netw Open , 2023 , 6 ( 10 ): e2337889 .

HSIN M K Y , LAM D C L . Can preoperative radiological identification of lung tumor invasiveness be improved? [J ] . JAMA Netw Open , 2023 , 6 ( 10 ): e2339175 .

AKINBOBOLA O , RAY MA , FEHNEL C , et al . Institution-level evolution of lung cancer resection quality with implementation of a lymph node specimen collection kit [J ] . J Thorac Oncol , 2023 , 18 ( 7 ): 858 - 868 . DOI: 10.1016/j.jtho.2023.03.002 http://doi.org/10.1016/j.jtho.2023.03.002

KENT M S , HARTWIG M G , VALLIÈRES E , et al . Pulmonary open, robotic, and thoracoscopic lobectomy (PORTaL) study: survival analysis of 6646 cases [J ] . Ann Surg , 2023 , 277 ( 6 ): 1002 - 1009 .

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