Chronic pulmonary aspergillosis (CPA) is a progressive fungal lung disease that often requires surgical intervention. Video-assisted thoracoscopic surgery (VATS) has emerged as a minimally invasive approach, and sublobar resection may offer potential benefits in selected patients by preserving lung parenchyma. This study aimed to describe the perioperative and long-term outcomes of VATS for CPA, with exploratory comparisons between sublobar and lobar resections. We retrospectively reviewed 151 patients with CPA who underwent VATS lung resection, categorized into simple aspergilloma (SA), chronic cavitary pulmonary aspergillosis (CCPA), and chronic necrotizing pulmonary aspergillosis (CNPA). Perioperative and long-term outcomes were analyzed across CPA subtypes and resection extents, and compared with a propensity score-matched lung cancer cohort. To account for treatment-selection imbalance in the sublobar-versus-lobectomy comparison, propensity score analyses were additionally performed within the CPA cohort. Of 151 patients, 90 had SA, 57 had CCPA, and 4 had CNPA. VATS was completed without conversion to open thoracotomy in all cases. Compared with the matched lung cancer cohort, CPA surgeries had longer operative times, more severe pleural adhesions, and higher postoperative complication rates. Among CPA patients, sublobar resection (n = 49) was associated with lower chest drainage volumes compared with lobectomy (n = 102), with similar overall complication rates (10.2

BACKGROUND:Lobectomy, a cornerstone in the treatment of various thoracic tumors, often requires postoperative chest drainage to prevent complications such as pneumothorax and pleural effusion. Traditional water-seal drainage systems have limitations, including inconvenience and restricted patient mobility. METHODS:This study investigated the safety and efficiency of a disposable dry seal chest drainage system compared to the traditional water-seal system in lobectomy patients. An open-label randomized controlled trial with trial registration number NCTO6410716 was conducted, including 82 patients undergoing elective three-port thoracoscopic lobectomy. The study assessed postoperative pain, functional recovery, complications such as DVT, and nursing workload. RESULTS:The results showed that the disposable dry seal chest drainage system significantly reduced nursing workload (p < 0.001) and improved patient mobility, with patients in the experimental group having significantly higher finger oxygen saturation levels on postoperative day 1 (p = 0.01) and day 2 (p < 0.001) compared to the control group. The incidence of DVT during the hospital stay was also lower in the experimental group (p = 0.032). Although no significant improvement in postoperative pain scores was observed, the improved functionality and reduced nursing workload suggest potential benefits for patient care and resource management. CONCLUSIONS:This study provides valuable insights into the potential advantages of the new drainage system and its alignment with enhanced recovery after surgery (ERAS) protocols, supporting its use as a superior option in postoperative chest drainage management for lobectomy patients.

ObjectiveThis study aimed to perform a single-center external validation of the recently adopted 9th edition TNM staging system for thymic epithelial tumors (TETs) and to propose a refined scheme addressing its prognostic stratification anomalies.MethodsWe conducted a retrospective cohort study of 540 patients with TETs treated at a single center from 2015 to 2021. All cases were rigorously re-staged according to 9th edition TNM criteria. The prognostic discrimination for overall survival (OS) and progression-free survival (PFS) of 9th edition TNM system was evaluated. Based on identified anomalies, a refined staging scheme was proposed.ResultsThe 9th edition TNM system demonstrated overall prognostic capability. However, significant stratification anomalies were observed: stage IIIA patients had paradoxically better OS and PFS than stage II patients, and the long-term survival curve of stage IIIB crossed below that of stage IV. Based on the extent of anatomical invasion, surgical complexity, and survival differences, we propose: (1) downgrading left brachiocephalic vein invasion to T2; (2) merging other T3/T4 lesions into a new T3 category (overall stage IIIA); (3) defining TanyN1M0 as stage IIIB; and (4) defining TanyN2M0 as stage IVA. Application of this refined scheme resulted in statistically significant, monotonically deteriorating trends for both OS and PFS across successive stages (P < 0.001), with markedly improved logical consistency.ConclusionThis single-center large-scale external validation reveals significant prognostic paradoxes in the 9th edition TNM system for TETs. The proposed refinement scheme effectively optimizes logical consistency and prognostic discrimination, offering potential implications for perioperative therapy planning.

Mucosa-associated lymphoid tissue (MALT) lymphoma is an extranodal low-grade non-Hodgkin lymphoma that extremely rarely localises to the mediastinum. A 34-year-old female with chronic arthralgia, sicca and rash was found to have a well-demarcated mediastinal cystic mass with equivocal nodular enhancement within the cystic wall on chest CT during a workup for Sjögren's syndrome. Subsequent 68Ga-Pentixafor-PET/CT revealed focal uptake increase within the cystic capsule. The patient underwent thoracoscopic resection of the mediastinal lesion, and pathology revealed MALT lymphoma in the wall of a thymic cyst. This case highlights that 68Ga-pentixafor PET/CT could be valuable for the non-invasive detection of occult thymic MALT lymphoma. Trial Registration: ClinicalTrials.gov. (www.clinicaltrials.gov, NCT06086327).

PURPOSE:This study was designed to evaluate 68 Ga-pentixafor, which targets C-X-C chemokine receptor 4 (CXCR4), in the noninvasive diagnosis of thymomas. PATIENTS AND METHODS:With institutional review board approval and signed informed consent, 32 patients with thymic masses were enrolled in this study, and all patients underwent 68 Ga-pentixafor PET/CT scans. RESULTS:Among the 28 patients included in the analysis, 13 patients were diagnosed with thymomas, 9 patients with cysts, and 6 patients with other anterior mediastinal masses. 68 Ga-pentixafor identified all patients with thymomas (13/13, 100%), and the mean SUV max in all 13 thymomas lesions was 13.96±8.20, which was significantly higher than that in patients with cysts (1.54±0.88) and other anterior mediastinal masses (2.59±1.68), respectively ( P <0.001). CONCLUSIONS:The preliminary study indicates the diagnostic utility of 68 Ga-pentixafor in thymomas and the differential diagnostic ability of 68 Ga-pentixafor in thymomas, thymic cysts and other benign anterior mediastinal masses.

Background:The accurate intraoperative localization of lung cancers presenting as ground-glass opacities (GGOs) in lung tissue remains challenging. Ultrahigh-frequency ultrasound (UHFUS), which allows for the visualization of micron-scale structures, may help address this issue. This study aimed to evaluate whether UHFUS can serve as a reliable intraoperative tool for real-time detection and localization of GGOs in excised lung specimens. Methods:This prospective observational study included patients with suspected lung cancer who underwent surgery between June 2023 and March 2024. Each excised GGO was sequentially detected and localized intraoperatively via palpation and UHFUS (22-38 MHz). The UHFUS features were independently examined and evaluated by two radiologists. Comparisons between localization rate and time consumption were analyzed with the McNemar and Wilcoxon signed-rank tests. Results:In total, 36 patients (55±10 years; 9 males) comprising 58 GGOs were included, of which 50 were small (≤1 cm) and 8 were general (>1 cm) GGOs; when grouped by density, 37 were considered pure and 21 mixed GGOs. UHFUS, as compared to palpation, demonstrated a superior localization rate for both small nodules (UHFUS: n=48, 96.0%; palpation: n=40, 80.0%; P=0.02) and pure GGOs (UHFUS: n=33, 94.3%; palpation: n=25; 71.4%; P=0.02). Even in the micronodule subgroup (≤5 mm), UHFUS showed better localization ability (n=15, 100%) than did palpation (n=12, 80%). For small GGOs, the median localization time of UHFUS [5 s, interquartile range (IQR) 5-8 s] was significantly shorter (P=0.003) than that for palpation (5 s, IQR 5-15 s); this difference was more pronounced (P=0.004) in pure GGOs (UHFUS: median 5 s, IQR 5-10 s; palpation: 12.5 s, IQR 5-20 s). On UHFUS, 83.3% of GGOs appeared as indistinct hypoechoic areas with posterior shadowing. UHFUS could detect new GGOs, and the agreement in diameter between UHFUS and pathology surpassed that between CT and pathology. Conclusions:This prospective observational trial supports the use of real-time, noninvasive, and radiation-free UHFUS for the intraoperative localization of GGOs in lung tissue. It has the potential to enhance the efficiency of lung surgery in detecting small tumors and identify new nodules.

BackgroundTo investigate the prognostic factors for stage IIb and IIIa lung adenocarcinoma following radical surgery and to explore the molecular mechanisms underlying these prognostic markers, focusing on the role of PIK3C2G.MethodsA retrospective analysis of patients with stage IIb or IIIa lung adenocarcinoma who underwent radical surgery between January 2017 and June 2023 was conducted. Baseline clinical and pathological data, surgical methods, and postoperative treatments were analyzed to assess overall survival (OS). Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors. Whole-exome sequencing (WES) was performed on a subset of the patients with preserved tumor tissues and no matched targeted therapies to identify high-frequency mutated genes. Functional experiments in A549 lung adenocarcinoma cells were performed to evaluate the role of the significant genes in tumor progression through cell proliferation, migration, invasion, apoptosis, and cell cycle assays.ResultsThe survival analysis of 877 stage IIb and IIIa lung adenocarcinoma cases revealed significant differences in clinical characteristics and outcomes. Stage IIb patients had a median OS of 58 months compared to 37 months for stage IIIa, with 5-year OS rates of 46.9% and 30.5%, respectively. Univariate and multivariate Cox regression identified pathological stage, number of positive lymph nodes, age, and targeted therapy as independent prognostic factors. WES of 184 patients with no matched targeted therapies revealed high-frequency mutations in genes such as TP53 and PIK3C2G, with the latter emerging as the most significant prognostic marker. Functional assays demonstrated that the knockdown of PIK3C2G in A549 cells significantly reduced proliferation, migration and invasion while promoting apoptosis and disrupting cell cycle progression.ConclusionPIK3C2G was identified as a significant prognostic marker in stage IIb and IIIa lung adenocarcinoma, with functional data supporting its therapeutic potential. Taken together, this study integrates clinical and molecular findings, which could be used as a reference to guide personalized treatment strategies.

Background: Thymoma is a malignant tumor originating from the thymic epithelium and can be associated with over 100 paraneoplastic syndromes (PNSs). Due to the low incidence of thymoma and the relative rarity of alopecia areata (AA) as an associated autoimmune disease, patients with thymoma combined with AA are relatively uncommon in clinical practice. As a result, the clinicopathological features and pathogenesis of such patients have been rarely investigated. Methods: This study retrospectively analyzed the clinical records of thymoma patients who underwent surgical treatment at Peking Union Medical College Hospital and Beijing Tongren Hospital from August 2014 to July 2019, with a focus on the clinicopathological features of thymoma patients with AA. Propensity score matching (PSM) was employed to create a 1:5 matched comparison group with thymoma patients without AA. Results: A total of 428 thymoma patients were included, among which 9 had AA. Using PSM, we matched 45 control patients without AA based on age and gender. The analysis revealed that thymoma patients with AA had a significantly higher proportion of myasthenia gravis (MG) [100.00% (9/9) vs. 66.67% (30/45), p = 0.049], although there were no significant differences between the AChR antibodies, Titin antibodies, MG severity, and the incidence of postoperative myasthenic crisis. However, the proportion of thymoma patients with AA who also had other PNSs besides MG was significantly higher [88.89% (8/9) vs. 6.67% (3/45), p < 0.001]. Additionally, CD4+/CD8+ T-cell inversion in the serum was observed at a much higher rate in thymoma patients with AA [100.00% (9/9) vs. 24.44% (11/45), p < 0.001]. Conclusions: We hypothesize that the pathogenesis of thymoma with AA differs from that of thymoma with MG, though there may be a correlation. The etiology of thymoma with AA may be attributed to abnormal autoimmune CD8+ T lymphocytes produced by the thymoma, which can also lead to other cytotoxic T-cell-mediated autoimmune diseases.

BACKGROUND:Cancer remains a major cause of mortality and a significant economic burden in China. Exploring the disparities in cancer patterns and control strategies between China and developed countries may offer valuable insights for policy formulation and enhance cancer management efforts. This study examined the incidence, mortality, and disability-adjusted life year (DALY) burden of cancer in China, and compared these metrics with those observed in the United States (US) and the United Kingdom (UK). METHODS:Data on cancer incidence, mortality, and DALYs for China, the US, and the UK were sourced from the GLOBOCAN 2022 online database and the Global Burden of Disease 2021 study (GBD 2021). We utilized Joinpoint regression models to analyze trends in cancer incidence and mortality across these countries, calculating annual percent changes (APCs) and determining the optimal joinpoints. RESULTS:In 2022, China recorded around 4,824,703 new cancer cases and 2,574,176 cancer-related deaths, contributing to 71,037,170 DALYs. China exhibited a lower cancer incidence rate compared to the US and the UK. Although cancer-related mortality in China is slightly lower than that in the UK, it is significantly higher than that in the US. Additionally, China experienced significantly higher DALY rates compared to both the US and UK. The cancer landscape in China was also undergoing significant changes, with a rapid rise in the incidence and burden of lung, colorectal, breast, cervical, and prostate cancers. Meanwhile, the incidence and burden of stomach cancer continued to decline. Although the incidence of liver and esophageal cancers was decreasing, the burden of liver cancer was increasing, while the burden of esophageal cancer remained largely unchanged. CONCLUSIONS:The cancer profile of China is shifting from that of a developing country to one more typical of a developed country. The ongoing population aging and the rise in unhealthy lifestyles are expected to further escalate the cancer burden in China. Consequently, it is crucial for Chinese authorities to revise the national cancer control program, drawing on successful strategies from developed countries, while also accounting for the regional diversity in cancer types across China.

Abstract Background We investigated the real-world efficacy of adjuvant therapy for stage I lung adenocarcinoma patients with pathological high-risk factors. Methods Study participants were enrolled from November 1, 2016 and December 31, 2020. Clinical bias was balanced by propensity score matching. Disease-free survival (DFS) outcomes were compared by Kaplan–Meier analysis. The Cox proportional hazards regression was used to identify survival-associated factors. p ≤ 0.05 was the threshold for statistical significance. Results A total of 454 patients, among whom 134 (29.5%) underwent adjuvant therapy, were enrolled in this study. One hundred and eighteen of the patients who underwent adjuvant therapy were well matched with non-treatment patients. Prognostic outcomes of the treatment group were significantly better than those of the non-treatment group, as revealed by Kaplan-Meier analysis after PSM. Differences in prevention of recurrence or metastasis between the targeted therapy and chemotherapy groups were insignificant. Adjuvant therapy was found to be positive prognostic factors, tumor size and solid growth patterns were negative. Conclusions Adjuvant therapy significantly improved the DFS for stage I lung adenocarcinoma patients with high-risk factors. Larger prospective clinical trials should be performed to verify our findings.

Objective To explore the risk factors for disease progression after initial treatment of type B thymomas using a predictive nomogram model. Methods A single-center retrospective study of patients with type B thymoma was performed. The Cox proportional hazard model was used for univariate and multivariate analyses. Variables with statistical and clinical significance in the multivariate Cox regression were integrated into a nomogram to establish a predictive model for disease progression. Results A total of 353 cases with type B thymoma were retrieved between January 2012 and December 2021. The median follow-up was 58 months (range: 1-128 months). The 10-year progression-free survival (PFS) was 91.8%. The final nomogram model included R0 resection status and Masaoka stage, with a concordance index of 0.880. Non-R0 resection and advanced Masaoka stage were negative prognostic factors for disease progression (p < 0.001). No benefits of postoperative radiotherapy (PORT) were observed in patients with advanced stage and non-R0 resection (p = 0.114 and 0.284, respectively). Conclusion The best treatment strategy for type B thymoma is the detection and achievement of R0 resection as early as possible. Long-term follow-up is necessary, especially for patients with advanced Masaoka stage and who have not achieved R0 resection. No prognostic benefits were observed for PORT.

Abstract Background Metastasis to the thyroid gland from lung adenocarcinoma is rare and challenging to diagnose due to similar histopathological features. This study aimed to analyze the clinicopathological characteristics of and treatment strategies for lung adenocarcinoma metastasis to the thyroid based on 11 years of institutional experience. Methods A retrospective study included patients with lung adenocarcinoma metastasis to the thyroid at our center from 2010 to 2023. Clinicopathological features and clinical outcomes were analyzed. Results Among 9714 lung adenocarcinoma patients, nine patients (five females, 55.6%) were diagnosed with thyroid metastasis, presenting primarily with cough symptoms. Most patients (88.9%) had synchronous tumors, whereas a minority (11.1%) had metachronous tumors. The median time from primary tumor diagnosis to metastasis was 4.8 months. Most patients developed bilateral thyroid metastases (88.9%). Diagnosis of thyroid metastasis was primarily through fine‐needle aspiration (FNA), with one case misdiagnosed as papillary thyroid carcinoma. Immunohistochemical staining revealed thyroid transcription factor‐1 (TTF‐1) and novel aspartic proteinase of pepsin family A (Napsin‐A) positivity and paired box 8 (PAX8) negativity. Genetic testing found epidermal growth factor receptor mutations in 71.4% of patients. The individualized comprehensive therapy included surgery, chemotherapy, immunotherapy, and targeted and supportive therapy. The median overall survival was 56.0 months, with a progression‐free survival of 12.7 months. Kaplan–Meier (K–M) analysis suggested improved survival with no advanced symptoms (p = 0.03) and targeted therapies (p = 0.05). Conclusions Lung adenocarcinoma metastasis to the thyroid is a rare disease, with an incidence of 0.1% among lung adenocarcinoma patients. Early treatment after symptom onset and personalized targeted therapies may improve prognosis. Despite rapid disease progression, favorable outcomes can be achieved with comprehensive treatment.

Lymph node (LN) metastasis is one of the predominant metastatic routes of non-small cell lung cancer (NSCLC) and is considered as a leading cause for the unsatisfactory prognosis of patients. Although lymphangiogenesis is well-recognized as a crucial process in mediating LN metastasis, the regulatory mechanism involving lymphangiogenesis and LN metastasis in NSCLC remains unclear. In this study, we employed high-throughput sequencing to identify a novel circular RNA (circRNA), circTLCD4-RWDD3, which was significantly upregulated in extracellular vesicles (EVs) from LN metastatic NSCLC and was positively associated with deteriorated OS and DFS of patients with NSCLC from multicenter clinical cohort. Downregulating the expression of EV-packaged circTLCD4-RWDD3 inhibited lymphangiogenesis and LN metastasis of NSCLC both in vitro and in vivo. Mechanically, circTLCD4-RWDD3 physically interacted with hnRNPA2B1 and mediated the SUMO2 modification at K108 residue of hnRNPA2B1 by upregulating UBC9. Subsequently, circTLCD4-RWDD3-induced SUMOylated hnRNPA2B1 was recognized by the SUMO interaction motif (SIM) of ALIX and activated ALIX to recruit ESCRT-III, thereby facilitating the sorting of circTLCD4-RWDD3 into NSCLC cell-derived EVs. Moreover, EV-packaged circTLCD4-RWDD3 was internalized by lymphatic endothelial cells to activate the transcription of PROX1 , resulting in the lymphangiogenesis and LN metastasis of NSCLC. Importantly, blocking EV-mediated transmission of circTLCD4-RWDD3 via mutating SIM in ALIX or K108 residue of hnRNPA2B1 inhibited the lymphangiogenesis and LN metastasis of NSCLC in vivo. Our findings reveal a precise mechanism underlying SUMOylated hnRNPA2B1-induced EV packaging of circTLCD4-RWDD3 in facilitating LN metastasis of NSCLC, suggesting that EV-packaged circTLCD4-RWDD3 could be a potential therapeutic target against LN metastatic NSCLC.

目的 探讨电视辅助胸腔镜(video-assisted thoracoscopic surgery,VATS)解剖性肺段切除术在同期和分期双侧肺癌手术患者中应用的安全性及有效性.方法 回顾性分析北京协和医院胸外科2013年12月-2022年5月收治的100例应用VATS解剖性肺段切除术进行双侧手术患者的临床资料.根据手术时机将患者分为两组:同期双侧手术组52例,其中男17例、女35例,年龄(55.17±11.09)岁;分期双侧手术组48例,其中男16例、女32例,年龄(59.88±11.48)岁.对两组患者的术中情况及术后疗效进行评价.结果 100例患者均顺利完成双侧VATS手术,至少一侧行解剖性肺段切除术.同期双侧手术组患者具有年龄小(P=0.040)、合并疾病比例小(P=0.030)、肺癌家族史罕见(P=0.018)及发现至手术间期更短(P=0.000)的特点.同期双侧手术组以肺段联合楔形切除术为主,分期双侧手术组以联合肺叶切除术为主(P=0.000);同期双侧手术苏醒时间较分期一期和二期手术更长(P=0.000,P=0.002),但手术时间、麻醉时间与分期双侧手术组两次叠加时间差异无统计学意义;淋巴结采样/清扫站数(P=0.041)及个数(P=0.026)较分期双侧手术组两次叠加数量更少;两组术中气道压管理差异无统计学意义(P＞0.05).同期双侧手术组出院后日常生活能力评分更低.结论 VATS解剖性肺段切除术在同期及分期双侧肺癌手术中的应用安全可行,对侧可联合亚肺叶或肺叶切除术.同期双侧手术组在手术时间和术后并发症与分期双侧手术组大致相同,但出院后日常生活能力评分更低.在综合考虑患者心理因素、身体情况及个人意愿的基础上可优先选择同期双侧手术.

Background: This study aimed to examine the treatment and prognosis of patients with type B2 + B3 thymoma and compare it with those patients with type B2 and B3 thymoma.Methods: We conducted a retrospective analysis of the results of 39 patients with type B2 + B3 thymoma, 133 patients with type B2 thymoma, and 64 patients with type B3 thymoma. The Kaplan-Meier technique was used to generate survival curves. For multivariate analysis, the Cox proportional hazard model was applied.Results: With a median follow-up of 60 months (range: 1-128 months), the percentage of patients with tumor, node, metastasis (TNM) stage III and IV disease gradually increased from 19.5% to 25.6% to 35.9% among those with histological subtypes B2, B2 + B3, and B3, respectively, p = 0.045. Twenty-three patients experienced recurrence or metastasis. The total 10-year progression-free survival (PFS) rates were 86.0% overall (85.0% in type B2, 87.2% in type B2 + B3, and 87.5% in type B3). Age, R0 resection, and Masaoka-Koga stage were found to have a significant on PFS in all patients. There was no statistically significant difference in PFS between different histotypes of thymoma, p = 0.650. PFS was predicted by R0 resection in all histotypes and by the Masaoka-Koga stage in the type B2 subgroup.Conclusion: Combining the two staging methods to guide the diagnosis and treatment of patients with B2 + B3 thymoma is recommended. R0 resection is recommended to reduce recurrence. Patients with B2 + B3 thymoma have a prognosis similar to those with a B2 thymoma or a B3 thymoma alone.

ABSTRACT:A 47-year-old man presented with right upper abdominal pain for 1 month. Contrast-enhanced CT revealed hilar bile duct stenosis with dilatation of the intrahepatic bile ducts, and his serum CA19-9 and CA242 levels were significantly elevated. 18F-FDG and 68Ga-FAPI PET/CT were performed for differential diagnosis. 18F-FDG PET/CT showed only mild FDG uptake in the hepatic hilum. Astonishingly, in 68Ga-FAPI PET/CT, intense radioactivity was presented on the same region, which indicated massive fibroblasts aggregation in hepatic hilum. The patient was finally diagnosed as portal biliopathy caused by cavernous transformation of the portal vein.

Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy, accounting for less than 1% of all uterine malignancies. And there is no literature reporting about acute obstruction of inferior vena cava (IVC) caused by LG-ESS. In November 2021, A patient diagnosed with LG-ESS was admitted to our hospital, presenting with pitting edema of the right lower limb, menstrual disturbance, nausea, oliguria andincreased serum creatinine. Imaging suggested complete obstruction of IVC cava. This difficult case was successfully treated with staging surgery combined with endocrine therapy by a cooperative multidisciplinary team (MDT). The important role of MDT in the treatment process of such a difficult and serious case was demonstrated.

Pulmonary inflammatory myofibroblastic tumor (PIMT) is a rare lung tumor that is poorly understood by clinicians. Based on the data of patients with PIMT in our center, a comprehensive search and a brief summary analysis of previous reports of the disease were carried out in this article. PIMTs were more likely to be present in male patients and in the right lung, and their clinical and radiographic findings were heterogeneous. Surgery is the most important treatment method, and complete resection is of great significance to the prognosis of patients. Targeted therapy represented by crizotinib may be helpful for patients with positive ALK mutations.

Background For early stage non-small cell lung cancer, whether limited resection can yield comparable outcomes to those of lobectomy hasn't been established. We compared Overall survival (OS) and lung cancer-specific survival (LCSS) after segmentectomy or lobectomy in stage IA1 (<= 10 mm) lung adenocarcinoma (LUAD) patients. Research design and methods We retrospectively recruited patients who'd been diagnosed with lung cancer for the first time and treated with segmentectomy or lobectomy, with or without previous other malignancy. Results 1788 patients were included. After propensity score matching: 5-year OS were 85.6% for segmentectomy and 84.7% for lobectomy (p=0.951); 5-year LCSS were 93.5% for segmentectomy; and 93.0% for lobectomy (p=0.726). Cox regression analysis revealed segmentectomy was comparable to lobectomy in OS and LCSS. Having a second lung cancer later in life was associated with a worse LCSS for lobectomy (p<0.05) rather than segmentectomy. After patients were stratified according to malignancy history, subgroup analyses showed no significant prognosis differences between two surgeries. Conclusions For stage IA1 LUAD patients who were diagnosed with lung cancer for the first time, with or without previous other malignancy, segmentectomy yields comparable outcomes to those of lobectomy. It may provide better outcomes for patients with multiple suspicious nodules.

Solitary fibrous tumor of the pleura (SFTP) is a rare mesenchymal neoplasm that originates from CD34+ dendritic stromal cells. While the majority of SFTPs are considered benign, an estimated 10%-20% are malignant. Malignant SFTP (MSFTP) is highly invasive and has propensities for local recurrence and distant metastasis. In recent years, an increasing number of MSFTPs have been reported. However, the diagnosis of MSFTP can be difficult owing to a lack of typical clinical manifestations and imaging features. To facilitate its diagnosis, the clinical, imaging, and histopathological characteristics of MSFTP are reviewed herein, followed by the clinical management such as surgery, radiotherapy, chemotherapy, targeted drugs and immunotherapy. Detection of NAB2-STAT6 fusion and expression of nuclear STAT6 can facilitate the diagnosis of SFTP. Furthermore, the recurrence risk stratification and prediction models of MSFTP as well as progress will be discussed. An improved understanding of these factors may contribute to more efficient diagnosis and management of MSFTP patients.