1. European experience on oncological outcomes of patients with early-stage non-small cell lung cancer and any prior cancer following lobectomy or segmentectomy Author links open overlay panelLukadi Joseph Lula, Rita Costa, Lin Huang, Amr Rushwan, Matic Domjan, A.J.P.M. Franssen, Rebecca Weedle, Beatrice Trabalza Marinucci, Clara Forcada Barreda, Črt Jašovič, Tomaž Štupnik, 2026, original scientific article Abstract: Objectives To assess the impact of lung resection extent on early-stage non-small cell lung cancer with a history of any cancer. Methods Retrospective multicentric cohort study including patients with ≤2 cm pathologic size lung cancer with a history of any cancer, operated on from 2015 to 2021 across nine European centers (one per country). Overall survival (OS), disease-free survival (DFS) and lung cancer specific death (LCSD) between both groups were assessed before and after propensity score (PS) −matching. Risk factors for oncologic outcomes were analyzed using parsimonious model cox proportional hazard regression. Kaplan Meier and cumulative incidence function assessed the outcomes. Log-rank test and Gray’ test compared the groups. Linearized risk was used to assess recurrences. Results Of the 1910 patients with early-stage lung cancer patients, 540 (28.2%) had a prior cancer. Lobectomy and segmentectomy were performed in 409 (75.7%) and 131 (24.3%) patients respectively. 5-year OS rates: lobectomy 81.5%, segmentectomy 80.8%, p = 0.8; DFS: lobectomy 76.9%, segmentectomy 74.4%, p = 0.6 and LCSD: lobectomy 8.0%, segmentectomy 4.9%, p = 0.2. These finding were similar in the matched cohort. Locoregional recurrence (linearized risk: lobectomy 0.111, segmentectomy 0.066) and distant recurrence (linearized risk: lobectomy 0.093, segmentectomy 0.055) were not worse in the segmentectomy group. In multivariable analysis, prior cancer negatively impacted only lung cancer specific death HR:1.27 (95%CI:1.00–1.60). Conclusion Compared to lobectomy, segmentectomy has not shown a worse oncologic outcome in patients with history of any prior cancer.
Keywords: segmentectomy, cancer, early-stage, non-small lung, canceroutcome
Published in DiRROS: 27.07.2026; Views: 314; Downloads: 173
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2. European prognosis evaluation of early-stage lung adenocarcinoma patterns after lobectomy versus segmentectomy based on clinical stage settingsLukadi Joseph Lula, Lin Huang, Clara Forcada Barreda, Rita Costa, Matic Domjan, A.J.P.M. Franssen, Črt Jašovič, Tomaž Štupnik, 2026, original scientific article Abstract: Objectives: To investigate the prognosis of peripheral early-stage lung adenocarcinoma patterns treated by lobectomy or segmentectomy. Methods: Retrospective multicentric cohort of patients with cT1a-bN0M0 lung adenocarcinoma who underwent lobectomy or segmentectomy with systematic lymph node dissection in 10 European centers (one per country) from 2015 to 2021. Overall survival (OS), disease-free survival (DFS), and lung cancer–specific death (LCSD) between both groups were assessed in entire dataset and in dataset of histologic aggressive patterns, before and after propensity score-matching (PSM). Prognostic risk factors were analyzed using parsimonious model Cox regression. Recurrences were assessed by linearized risks. Results: Lobectomy and segmentectomy were performed in 1029 (73.1%) and 377 (26.8%) patients, respectively. In total, 427 (30.3%) patients had at least 1 histologic aggressive (micropapillary or solid) pattern, and 88 patients (20.7%) underwent segmentectomy. OS, DFS, and LCSD rates were similar between patients who underwent lobectomy or segmentectomy, in both datasets, before and after PSM. In aggressive dataset, PSM, 5-year OS rates were lobectomy 88.0% (95% CI, 80.9-95.7%), segmentectomy 89.1% (95% CI, 82.2-96.6%), P = .8; 5-year DFS rates were lobectomy 79.8% (95% CI, 70.8-89.8%), segmentectomy 80.6% (95% CI, 71.6-90.6%), P = .6; and 5-year LCSD rates were lobectomy 6.0%, segmentectomy 7.8%, P = .8. Locoregional recurrence was not superior in patients who underwent segmentectomy in entire dataset (linearized risks: lobectomy 0.078, segmentectomy 0.073) and in aggressive dataset (linearized risks: lobectomy 0.036, segmentectomy 0.011) only in the unmatched cohorts. Aggressive histologic patterns impacted on only LCSD, and only when they were dominant. Conclusions: Segmentectomy seems comparable to lobectomy for patients with peripheral cT1a-bN0M0 lung adenocarcinoma even in case of histologic aggressive patterns.
Keywords: lobectomy, lung adenocarcinoma, segmentectomy, patterns, prognosis
Published in DiRROS: 24.04.2026; Views: 374; Downloads: 165
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3. The role of video-assisted thoracoscopic surgery in blunt and penetrating chest trauma : timing of intervention and clinical outcomes - a review of the current evidenceAkshay J. Patel, Matic Domjan, Haruchika Yamamoto, 2025, review article Abstract: Video-assisted thoracoscopic surgery (VATS) has emerged as a valuable tool in the management of both blunt and penetrating chest trauma. Indications for VATS include retained haemothorax, persistent pneumothorax, and diagnostic clarification of suspected intrathoracic injuries. Compared to open thoracotomy, VATS offers reduced postoperative pain, shorter hospital stay, and decreased infection rates, particularly when performed early, ideally within 72 hours of injury. In cases of blunt trauma, early VATS enables effective evacuation of clotted blood, reduces ventilator days, and minimizes complications such as empyema or fibrothorax. In penetrating trauma, VATS allows for minimally invasive inspection and management of diaphragmatic, pulmonary, and pleural injuries in haemodynamically stable patients, with early intervention showing superior outcomes. The role of VATS in rib fracture stabilization is expanding, with data supporting its feasibility and effectiveness in anatomically challenging cases, such as posterior or subscapular fractures. Thoracoscopic-assisted fixation may offer comparable or superior outcomes to open techniques, particularly when novel devices like memory alloy plates are used. While early surgical stabilization of rib fractures (SSRF) is generally favoured, recent evidence suggests that delayed SSRF does not necessarily worsen clinical outcomes, allowing prioritization of other life-threatening injuries in polytrauma scenarios. Despite promising retrospective and cohort data, there remains a lack of randomized controlled trials (RCTs) to definitively guide timing and patient selection for VATS in trauma. Standardized protocols for integrating VATS into trauma algorithms are needed. This review synthesizes current evidence and proposes pragmatic recommendations for the timing and indications of VATS in modern thoracic trauma care.
Keywords: video-assisted thoracoscopic surgery, VATS, thoracic trauma, rib fixation, blunt trauma, penetrating trauma
Published in DiRROS: 06.01.2026; Views: 859; Downloads: 304
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