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Background and objective Lung large cell neuroendocrine carcinoma (LCNEC) is a rare and highly malignant lung tumor with a poor prognosis. Currently, most research on LCNEC is based on retrospective studies and lacks validation in the real world. The study aims to identify independent risk factors and establish and validate a predictive model for the prognosis of LCNEC. Methods Patient data were extracted from Surveillance, Epidemiology, and End Results (SEER) and our department's hospitalization records from 2010 to 2015 and 2016 to 2020, respectively. Kaplan-Meier analysis was used to evaluate overall survival (OS). OS is defined as the time from diagnosis to death or last follow-up for a patient. Univariate and multivariate Cox regression analyses were performed to identify significant prognostic factors and construct a Nomogram for predicting the prognosis of LCNEC. Results In total, 1892 LCNEC patients were included and divided into a training cohort (n=1288) and two validation cohorts (n=552, n=52). Univariate Cox regression analysis showed that age, gender, primary tumor site, laterality, T stage, N stage, M stage, surgery, and radiotherapy were factors that could affect the prognosis of LCNEC patients (P<0.05). Multivariate Cox analysis indicated that age, gender, primary tumor site, T stage, N stage, M stage, surgery, and radiotherapy were independent risk factors for the prognosis of LCNEC patients (P<0.05). Calibration curves and the concordance index (internal: 0.744±0.015; external: 0.763±0.020, 0.832±0.055) demonstrated good predictive performance of the model. Conclusion Patients aged >65 years, male, with advanced tumor-node-metastasis (TNM) staging, and who have not undergone surgery or radiotherapy have a poor prognosis. Nomogram can provide a certain reference for personalized clinical decision-making for patients. [ABSTRACT FROM AUTHOR]

The emergence of immune checkpoint inhibitors (ICIs) has dramatically changed the therapeutic outlook for patients with non-small cell lung cancer (NSCLC). Preoperative neoadjuvant immunotherapy has been paid more and more attention as an effective and safe treatment. Neoadjuvant immune therapy, however, the relevant research started late, relatively few research results and mainly focused on the small sample size of phase I and II studies, treatment itself exists many places it is not clear, also in benefit population screening, the respect such as the choice of treatment and curative effect prediction has not yet reached broad consensus. This paper reviews the important studies and recent achievements related to neoadjuvant immunotherapy, aiming to comprehensively discuss the procedures and existing problems of this kind of therapy from three aspects of beneficiary groups, treatment cycle and efficacy prediction. [ABSTRACT FROM AUTHOR]

Tumor immunotherapy is a new therapy which developed in recent years, it has greatly changed the therapeutic schedules and brought new options for patients. However, not all patients can have obvious therapeutic effects after using immunotherapy. So selecting more suitable patients and raising immunotherapy effect are worthy to discuss. With the research of circular RNAs (circRNAs), circRNAs have been found that they not only play a significant role in the field of tumor markers, tumor progression and prognosis, but also can abnormally express in a variety of tumors and affect tumor immunity. Therefore, the circRNAs expression may not only can be used as a supplementary method for selecting patients, but also can be used to predict the efficacy of tumor immunotherapy. In this article, we summarize current knowledge on circRNAs abnormally expressed in many cancers, especially lung cancer which can affect tumor immunity, and discuss its potential effects in tumor immunotherapy, and we hope to provide more references for the clinical practice of circRNAs. [ABSTRACT FROM AUTHOR]

Background and objective Lung segmentectomy is increasingly used to resect lung nodules. Video-assisted thoracic surgery (VATS) is widely chosen to performing lung segmentectomy, while robotic assisted thoracoscopic (RATS) was also one useful and practical method. There article was intended to compared the short-time outcomes of RATS and VATS in lung segmentectomy. Methods The patients with lung nodules underwent segmentectomy by either RATS or VATS from January 2016 to April 2017 were studied. Baseline characteristics and short-time outcomes (dissected lymph nodes, postoperative duration of drainage, postoperative hospital stay, incidence of pro-longed air leak, atrial fibrillation and pneumonia) were compared. Results 166 patients were included in this study: 81 patients underwent RATS segmentectomy while 85 underwent VATS segmentectomy. The number of lymph nodes dissected in RATS group was more than in VATS group [(13.07±5.08) vs (10.81±5.74), P=0.010 ] . The incidence of some postoperative complications such as pro-longed air leak, atrial fibrillation was not significant different between the two approaches. Conclusion Compared with VATS, RATS has similar safety and operability, and the number of lymphadenectomy is significantly more than that of VATS. [ABSTRACT FROM AUTHOR]

Background and objective More patients with pulmonary nodules are being referred to thoracic surgeons under the increasing use of computed tomography scans (CT). Impalpable peripheral subpleural solitary pulmonary nodules are difficult to be localized by video assisted thoracic surgery. Although some common techniques including CT-guided puncture positioning and electromagnetic navigation bronchoscopy (ENB)-guided methylene blue staining positioning, can bring good results in positioning, there are still some complications such as pneumothorax, hemorrhage and inaccurate positioning. Vectorial localization guided by electromagnetic navigational bronchoscopy followed by thoracoscopic resection is a novel alternative technique by us firstly for definitive diagnosis, which can avoid the possible injury of pleural or enlargement of the location area, providing some guidance for ENB-guided location technology. The main objective of this study was to evaluate the feasibility and our initial experience of vectorial localization guided by electromagnetic navigation followed by video-assisted thoracoscopic pulmonary solitary nodules resection. Methods We retrospectively analyzed 22 cases who undergoing vectorial localization of peripheral pulmonary lesion guided by electromagnetic navigation prior to video assisted lung resection, and characteristics and intraoperative outcomes were explored. Results Twenty-two nodules of twenty-two patients were all localized by this method successfully with an average location time (17.5±4.2) min. The average nodule size was (11.0±3.6) mm. The distance between the locatable guide probe (LG) and lesion on the electromagnetic navigation bronchoscopy screen was (14.5±10.1) mm. The distance between the lesion and probe mark on the dissected specimen was (15.3±11.0) mm. There was no displacement of any case. No conversion to thoracotomy was found. And there were no adverse events during the localization and operation procedure. Length of hospital stay was (3.8±1.2) and the operative mortality was 0.0%. Malignant lesions were found in 19 patients and they were all completely resected with negative microscopic margins. Conclusion Our initial experience with vectorial localization of peripheral pulmonary lesion guided by electromagnetic navigation and minimally invasive resection proved that this technique was an alternative accurate and safe way for small pulmonary nodules. Toracic surgeons should further investigate this method and apply it to clinical practice. [ABSTRACT FROM AUTHOR]

Lung cancer is the most common cancer and the leading cause of cancer death. Non-small cell lung cancer (NSCLC) represents over 85% of all lung cancers, and up to 50% of Asian NSCLC patients harboring epidermal growth factor receptor (EGFR) gene mutations. A number of studies have consistently demonstrated that uncommon EGFR-mutated NSCLC patients treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can achieve better survival outcomes. However, because uncommon EGFR mutations are generally associated with reduced sensitivity to EGFR-TKIs, which will bring a negative impact on the result of the study, the majority of clinical trials investigating the efficacy of EGFR-TKIs have included only patients with common EGFR mutations. In addition, uncommon EGFR mutations are rare in themselves, leading to the small number of such patients enrolled in these trials. Due to the small number and highly heterogeneous sensitivity of uncommon EGFR mutations, the efficacy of EGFR-TKIs in patients harboring uncommon EGFR mutations remains elusive. This article reviews the efficacy of EGFR-TKIs in patients with uncommon EGFR mutations, and give some reasonable advice about the selection of treatments for patients with NSCLC who harbor uncommon EGFR mutations. [ABSTRACT FROM AUTHOR]

In recent years, the incidence and detection rate of lung cancer have gradually increased, and segmentectomy has been increasingly used to treat early non-small cell lung cancer. Some scholars believe that segmentectomy is more conducive to the preservation of postoperative lung function than lobectomy. Some studies have found that the two surgical methods have little difference in postoperative cost retention. This article deals with segmentectomy and lobectomy. A review of related studies on postoperative pulmonary function changes. [ABSTRACT FROM AUTHOR]