2023年度肺癌外科治疗领域重要进展

钱斌; 陈海泉

doi:10.19401/j.cnki.1007-3639.2024.04.001

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2023年度肺癌外科治疗领域重要进展

专家述评 | 更新时间：2025-12-31

- 2023年度肺癌外科治疗领域重要进展
- Important progress in surgical treatment of lung cancer in 2023
- 中国癌症杂志 2024年34卷第4期页码：335-339
- 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：
  
  [ "钱斌（ORCID: 0009-0007-9228-9962），主任医师，扬州市江都人民医院胸外科主任。" ]
  [ "陈海泉，医学博士、主任医师、二级教授、博士研究生导师。现任复旦大学胸部肿瘤研究所所长，复旦大学附属肿瘤医院胸外科主任、胸部肿瘤多学科诊治组首席专家、肺癌防治中心主任。曾任上海市胸科医院院长。现为美国胸外科学会会员、教育委员会委员、会员发展委员会委员、美国胸外科学会胸外科临床实践标准委员会委员、美国胸外科学会GGO肺癌处理专家共识主席、哈佛大学Schuster Distinguished Lectureship、中国医师协会胸外科医师分会副会长、中国抗癌协会肺癌专业委员会常委、食管癌专业委员会常委、上海医学会胸外科分会主任委员、上海市抗癌协会肺癌专委会主任委员、上海市领军人才、上海市优秀学科带头人。目前任The Journal of Thoracic and Cardiovascular Surgery编委，Journal of Cancer Research and Clinical Oncology、Annals of Surgical Oncology和JTO Clinical and Research Reports副主编。在国际上创新性地提出了“肺癌微创3.0”、“冰冻病理指导亚肺叶切除”和“肺癌手术的选择性淋巴结清扫”。2013—2023年连续每年应邀至AATS讲课，2016年担任AATS第96届年会Skill Course的共同主席、2016年AATS Focus on Thoracic Surgery：China主席，2017年第9届亚洲胸外科俱乐部（ATSC）和韩国胸外科肿瘤协会（KATSO）联席会议副主席，2008年起先后多次应邀在美国匹兹堡大学医学中心、美国哈佛大学麻省总医院、美国纽约纪念斯隆-凯特林癌症中心、美国范德堡大学医学中心、瑞士苏黎世大学医学中心、比利时鲁汶大学医学中心授课。2020年在美国哈佛大学布列根和妇女医院授课（Schuster Distinguished Lectureship），2020年在日本呼吸器外科学会（JACS）第37届年会特邀授课。2017年起应邀为The Journal of Thoracic and Cardiovascular Surgery撰写评论文章11篇。相关成果累计在Journal of Clinical Oncology、Cancer Cell、Journal of Thoracic Oncology、Chest、Annals of Surgery、The Journal of Thoracic and Cardiovascular Surgery等国际权威期刊上发表论文260余篇，其中7篇为基本科学指标数据库（Essential Science Indicators，ESI）高被引论文，33篇论文共41次写入17项肺癌诊治国际指南和分子检测国际指南。建立的治疗方案使肺癌患者术后5年生存率超越国际水平10%，被国际专家誉为“肺癌外科个体化治疗向前迈进的重要一步”和“精准医学时代的精准外科”，树立了国际胸部肿瘤外科诊治的新标杆，在国际上得到广泛推广和应用。" ]
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2024.04.001
  中图分类号： R734.2
- 收稿：2024-03-28，
  
  修回：2024-04-28，
  
  纸质出版：2024-04-30
- 稿件说明：
移动端阅览
钱斌, 陈海泉. 2023年度肺癌外科治疗领域重要进展[J]. 中国癌症杂志, 2024,34(4):335-339.

Bin QIAN, Haiquan CHEN. Important progress in surgical treatment of lung cancer in 2023[J]. China Oncology, 2024, 34(4): 335-339.
钱斌, 陈海泉. 2023年度肺癌外科治疗领域重要进展[J]. 中国癌症杂志, 2024,34(4):335-339. DOI： 10.19401/j.cnki.1007-3639.2024.04.001.

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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