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Chen T, Chan EG, Huang B, Bertolaccini L, Fernando HC, Tasoudis PT, Motas N, Pennathur A, Fang W, Zhang J. Outcomes following minimally invasive approaches vs. open extended lobectomy for non-small cell lung cancer: a propensity-matched analysis of the National Cancer Database. Transl Lung Cancer Res 2024; 13:334-344. [PMID: 38496690 PMCID: PMC10938095 DOI: 10.21037/tlcr-24-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/18/2024] [Indexed: 03/19/2024]
Abstract
Background Traditional thoracotomy, an invasive surgical procedure, has been the standard approach for extended lobectomy in treating non-small cell lung cancer (NSCLC). However, minimally invasive surgery (MIS) has gained traction with advancements in surgical techniques. Despite this, the outcomes of extended lobectomy via a minimally invasive approach remain largely uncharted. Using the comprehensive National Cancer Database (NCDB), our research aimed to clarify the safety, feasibility, and efficacy of minimally invasive extended lobectomy in patients diagnosed with NSCLC. Methods Our study encompassed a selection of patients with NSCLC who underwent extended lobectomy (defined as lobectomy or bilobectomy with chest wall, diaphragm or pericardial resection) between 2010 and 2014. Through propensity score matching (PSM), we ensured a balanced comparison between patients who underwent MIS and those who opted for the traditional open extended lobectomy. Both univariate and multivariate analyses were employed to discern whether the surgical approach had any significant impact on the prognosis of patients undergoing this specific procedure. Results Before PSM, our dataset included 3,934 patients. After 1:2 PSM, the MIS group included 683 cases, while the open group included 1,317 cases. One notable finding was the reduced average postoperative hospital stay for the MIS group at 7.15 days compared to the open group at 8.40 days (P<0.001). Furthermore, the 5-year survival rate was similar, with the MIS group at 53.1% and the open group at 51.3% (P=0.683). Conclusions The results of our study suggest that MIS for extended lobectomy not only is safe and feasible but also is oncologically effective. However, it is imperative to note that these encouraging findings necessitate further validation through prospective studies to ascertain the full scope of benefits and potential risks associated with MIS.
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Affiliation(s)
- Tangbing Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ernest G. Chan
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Binhao Huang
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Hiran C. Fernando
- Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Panagiotis T. Tasoudis
- Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Natalia Motas
- Department of Thoracic Surgery, Institute of Oncology Bucharest, Bucharest, Romania
- Clinic of Thoracic Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Thoracic Surgery, Memorial Hospital, Bucharest, Romania
| | - Arjun Pennathur
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
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Maxwell CM, Bhat AM, Falls SJ, Bigbee M, Yin Y, Chalikonda S, Bartlett DL, Fernando HC, Allen CJ. Comprehensive value implications of surgeon volume for lung cancer surgery: Use of an analytic framework within a regional health system. JTCVS Open 2024; 17:286-294. [PMID: 38420536 PMCID: PMC10897681 DOI: 10.1016/j.xjon.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 03/02/2024]
Abstract
Objective We used a framework to assess the value implications of thoracic surgeon operative volume within an 8-hospital health system. Methods Surgical cases for non-small cell lung cancer were assessed from March 2015 to March 2021. High-volume (HV) surgeons performed >25 pulmonary resections annually. Metrics include length of stay, infection rates, 30-day readmission, in-hospital mortality, median 30-day charges and direct costs, and 3-year recurrence-free and overall survival. Multivariate regression-based propensity scores matched patients between groups. Metrics were graphed on radar charts to conceptualize total value. Results All 638 lung resections were performed by 12 surgeons across 6 hospitals. Two HV surgeons performed 51% (n = 324) of operations, and 10 low-volume surgeons performed 49% (n = 314). Median follow-up was 28.8 months (14.0-42.3 months). Lobectomy was performed in 71% (n = 450) of cases. HV surgeons performed more segmentectomies (33% [n = 107] vs 3% [n = 8]; P < .001). Patients of HV surgeons had a lower length of stay (3 [2-4] vs 5 [3-7]; P < .001) and infection rates (0.6% [n = 1] vs 4% [n = 7]; P = .03). Low-volume and HV surgeons had similar 30-day readmission rates (14% [n = 23] vs 7% [n = 12]; P = .12), in-hospital mortality (0% [n = 0] vs 0.6% [n = 1]; P = .33), and oncologic outcomes; 3-year recurrence-free survival was 95% versus 91%; P = .44, and 3-year overall survival was 94% versus 90%; P = 0. Charges were reduced by 28%, and direct costs were reduced by 23% (both P < .001) in the HV cohort. Conclusions HV surgeons provide comprehensive value across a health system. This multidomain framework can be used to help drive oncologic care decisions within a health system.
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Affiliation(s)
- Conor M Maxwell
- Allegheny Health Network Singer Research Institute, Pittsburgh, Pa
| | - Akash M Bhat
- Drexel University College of Medicine, Philadelphia, Pa
| | - Samantha J Falls
- Allegheny Health Network Singer Research Institute, Pittsburgh, Pa
| | - Matthew Bigbee
- Allegheny Health Network Singer Research Institute, Pittsburgh, Pa
| | - Yue Yin
- Allegheny Health Network Singer Research Institute, Pittsburgh, Pa
| | - Sricharan Chalikonda
- Division of Surgical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pa
| | - David L Bartlett
- Division of Surgical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pa
| | - Hiran C Fernando
- Division of Thoracic and Esophageal Surgery, Allegheny Health Network, Pittsburgh, Pa
| | - Casey J Allen
- Division of Surgical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pa
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Abstract
OBJECTIVE Pain requiring opioid use remains an issue even with minimally invasive thoracic surgery. The objective of this study was to investigate the effectiveness of intercostal nerve cryoablation (CRYO) for pain control in adult patients undergoing pulmonary resection. METHODS A retrospective analysis of patients undergoing pulmonary resection by uniportal video-assisted thoracic (uVATS) approach was undertaken. Patients treated with our usual pain regimen (STANDARD) were compared with those who additionally received CRYO. STANDARD includes intercostal bupivacaine, patient-controlled analgesia (24 h), ketorolac (48 to 72 h), and tramadol. Intraoperative CRYO was performed on 5 intercostal levels. The primary aim was to compare pain scores (range, 0 to 10) and morphine equivalent dosages (MED). Secondary outcomes included length of stay, chest tube duration, presence of an air leak, and adverse events. A p value <0.05 was considered significant. RESULTS There were 49 patients (34 female, 15 male). The median age was 74 (37 to 90) years. Procedures included lobectomy (n = 32), segmentectomy (n = 7), and wedge resections (n = 10). There were 23 (46.9%) CRYO and 26 (53.1%) STANDARD patients. Baseline characteristics were similar. Mean length of stay (2.9 vs 3.5 days), chest tube duration (2.2 vs 1.8 days), and adverse events (9 of 23 vs 7 of 26) were similar. There were no complications attributable to CRYO. Pain scores were not significantly different on postoperative days (POD) 1 to 4. MED was significantly reduced after CRYO on POD 1 (5 vs 47.24), POD 2 (10.93 vs 25.04), POD 3 (8.13 vs 21.7), and POD 4 (7.08 vs 19.17). CONCLUSIONS CRYO can be performed safely during pulmonary resection and can decrease in-hospital opioid use. The results from this retrospective study will need to be validated in future prospective studies.
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Affiliation(s)
- Conor M Maxwell
- Department of General Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Benny Weksler
- Division of Thoracic and Esophageal Surgery, Allegheny Health Network, Pittsburgh, PA, USA
| | - Joseph Houda
- Division of Thoracic and Esophageal Surgery, Allegheny Health Network, Pittsburgh, PA, USA
| | - Hiran C Fernando
- Division of Thoracic and Esophageal Surgery, Allegheny Health Network, Pittsburgh, PA, USA
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Shen Y, Chen X, Hou J, Chen Y, Fang Y, Xue Z, D'Journo XB, Cerfolio RJ, Fernando HC, Fiorelli A, Brunelli A, Cang J, Tan L, Wang H. The effect of enhanced recovery after minimally invasive esophagectomy: a randomized controlled trial. Surg Endosc 2022; 36:9113-9122. [PMID: 35773604 PMCID: PMC9652161 DOI: 10.1007/s00464-022-09385-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/06/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The purpose of this randomized controlled trial was to determine if enhanced recovery after surgery (ERAS) would improve outcomes for three-stage minimally invasive esophagectomy (MIE). METHODS Patients with esophageal cancer undergoing MIE between March 2016 and August 2018 were consecutively enrolled, and were randomly divided into 2 groups: ERAS+group that received a guideline-based ERAS protocol, and ERAS- group that received standard care. The primary endpoint was morbidity after MIE. The secondary endpoints were the length of stay (LOS) and time to ambulation after the surgery. The perioperative results including the Surgical Apgar Score (SAS) and Visualized Analgesia Score (VAS) were also collected and compared. RESULTS A total of 60 patients in the ERAS+ group and 58 patients in the ERAS- group were included. Postoperatively, lower morbidity and pulmonary complication rate were recorded in the ERAS+ group (33.3% vs. 51.7%; p = 0.04, 16.7% vs. 32.8%; p = 0.04), while the incidence of anastomotic leakage remained comparable (11.7% vs. 15.5%; p = 0.54). There was an earlier ambulation (3 [2-3] days vs. 3 [3-4] days, p = 0.001), but comparable LOS (10 [9-11.25] days vs. 10 [9-13] days; p = 0.165) recorded in ERAS+ group. The ERAS protocol led to close scores in both SAS (7.80 ± 1.03 vs. 8.07 ± 0.89, p = 0.21) and VAS (1.74 ± 0.85 vs. 1.78 ± 1.06, p = 0.84). CONCLUSIONS Implementation of an ERAS protocol for patients undergoing MIE resulted in earlier ambulation and lower pulmonary complications, without a change in anastomotic leakage or length of hospital stay. Further studies on minimizing leakage should be addressed in ERAS for MIE.
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Affiliation(s)
- Yaxing Shen
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10021, China
| | - Xiaosang Chen
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Junyi Hou
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Youwen Chen
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Yong Fang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Zhanggang Xue
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Xavier Benoit D'Journo
- Department of Thoracic Surgery and Diseases of Esophagus, Aix-Marseille University, North Hospital, Chemin des Bourrely, 13915, Marseille Cedex 20, France
| | - Robert J Cerfolio
- Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY, USA
| | - Hiran C Fernando
- Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Università Della Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St. James's University Hospital, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - Jing Cang
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Lijie Tan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
| | - Hao Wang
- Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
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Maxwell CM, Fernando HC. Resect a little, resect more, irradiate or ablate—what is the best approach? J Thorac Dis 2022; 14:3108-3110. [PMID: 36245579 PMCID: PMC9562515 DOI: 10.21037/jtd-22-1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/21/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Conor M. Maxwell
- Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Hiran C. Fernando
- Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
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Teke ME, Sarvestani AL, Hernandez JM, Fernando HC, Timmerman RD. A Randomized, Phase III Study of Sublobar Resection (SR) Versus Stereotactic Ablative Radiotherapy (SAbR) in High-Risk Patients with Stage I Non-Small Cell Lung Cancer (NSCLC). Ann Surg Oncol 2022; 29:4686-4687. [PMID: 35524087 DOI: 10.1245/s10434-022-11584-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/26/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Martha E Teke
- Surgical Oncology Program, National Cancer Institute, NationalInstitutesofHealth, Building 10, Room 4-3740, Bethesda, MD, 20892, USA
| | - Amber Leila Sarvestani
- Surgical Oncology Program, National Cancer Institute, NationalInstitutesofHealth, Building 10, Room 4-3740, Bethesda, MD, 20892, USA
| | - Jonathan M Hernandez
- Surgical Oncology Program, National Cancer Institute, NationalInstitutesofHealth, Building 10, Room 4-3740, Bethesda, MD, 20892, USA.
| | - Hiran C Fernando
- Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Allegheny Health Network, Pittsburgh, PA, USA
| | - Robert D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, 2280 Inwood Rd., Dallas, TX, USA.
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Hochhegger B, Camargo S, da Silva Teles GB, Chate RC, Szarf G, Guimarães MD, Gross JL, Barbosa PNVP, Chiarantano RS, Reis RM, Mauad EC, Ghefter M, Sarmento P, Pereira R, Rocha J, Albuquerque ML, Miotto A, Almeida Dias DC, Franceschini JP, Fernando HC, Dos Santos RS. Challenges of Implementing Lung Cancer Screening in a Developing Country: Results of the Second Brazilian Early Lung Cancer Screening Trial (BRELT2). JCO Glob Oncol 2022; 8:e2100257. [PMID: 35073147 PMCID: PMC8789215 DOI: 10.1200/go.21.00257] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This paper aims to present the results of a series of several Brazilian institutions that have been carrying out lung cancer screening (LCS). MATERIALS AND METHODS This is a retrospective, cohort study, with follow-up of individuals of both sexes, with a heavy smoking history, who participated in LCS programs between December 2013 and January 2021 in six Brazilian institutions located in the states of São Paulo, Rio Grande do Sul, and Bahia. RESULTS Three thousand four hundred seventy individuals were included, of which 59.8% were male (n = 2,074) and 50.6% were current smokers (n = 1,758), with 60.7 years (standard deviation 8.8 years). Lung-RADS 4 was observed in 233 (6.7%) patients. Biopsy was indicated by minimally invasive methods in 122 patients (3.5%). Two patients who demonstrated false-negative biopsies and lung cancer were diagnosed in follow-up. Diagnosis of lung cancer was observed in 74 patients (prevalence rate of 2.1%), with 52 (70.3%) in stage I or II. Granulomatous disease was found in 20 patients. There were no statistical differences in the incidence of lung cancer, biopsies, granulomatous disease, and Lung-RADS 4 nodules between public and private patients. CONCLUSION There are still many challenges and obstacles in the implementation of LCS in developing countries; however, our multi-institutional data were possible to obtain satisfactory results in these scenarios and to achieve similar results to the main international studies. Granulomatous diseases did not increase the number of lung biopsies. The authors hope that it could stimulate the creation of organized screening programs in regions still endemic for tuberculosis and other granulomatous diseases. Challenges still remaining for lung cancer screening. Multi institutional BRELT2 reported good results in Brazil![]()
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Affiliation(s)
- Bruno Hochhegger
- Santa Casa de Misericórdia de Porto Alegre, PAVILHÃO PEREIRA FILHO, Porto Alegre, RS, Brazil.,Department of Radiology, University of Florida, Gainesville, FL
| | - Spencer Camargo
- Santa Casa de Misericórdia de Porto Alegre, PAVILHÃO PEREIRA FILHO, Porto Alegre, RS, Brazil
| | | | | | - Gilberto Szarf
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | | | | | | | | | | | - Mario Ghefter
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,ProPulmão Program São Paulo, SP, Brazil
| | | | | | - José Rocha
- Cardiopulmonar Hospital, Salvador, BA, Brazil
| | | | | | | | | | | | - Ricardo Sales Dos Santos
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,SENAI CIMATEC University Center, Salvador, BA, Brazil
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Shen J, Kong M, Yang H, Jin K, Chen Y, Fang W, Yu Z, Mao W, Xiang J, Han Y, Chen Z, Yang H, Wang J, Pang Q, Zheng X, Yang H, Li T, Zhang X, Li Q, Wang G, Mao T, Guo X, Lin T, Liu M, Ma D, Ye M, Wang C, Wang Z, Brunelli A, Cerfolio RJ, D’Journo XB, Fernando HC, Lordick F, Fu J, Chen B, Zhu C. Pathological complete response after neoadjuvant treatment determines survival in esophageal squamous cell carcinoma patients (NEOCRTEC5010). Ann Transl Med 2021; 9:1516. [PMID: 34790722 PMCID: PMC8576689 DOI: 10.21037/atm-21-3331] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/17/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Few studies have exclusively investigated the value of pathological complete response (pCR), in esophageal squamous cell carcinoma (ESCC) patients, although it is a clinically significant parameter to evaluate the impact of neoadjuvant chemoradiotherapy (nCRT) on treatment outcome after surgery. The aim of our study was to explore the relationship between pCR after nCRT and survival among patients with local ESCC. METHODS All patients receiving nCRT followed by surgery in NEOCRTEC5010-trial (NCT01216527) were included. Non-pCR patients were classified into three subgroups: ypTanyN0M0, ypT0NanyM0 and ypTanyNanyM0. The Kaplan-Meier method with log-rank test was employed to evaluate disease-free survival (DFS) and overall survival (OS). Multivariate regression analysis was performed using a Cox proportional hazards model to identify clinicopathological parameters associated with pCR. RESULTS Among the 185 patients included, 80 (43.2%) achieved pCR after nCRT. The mean survival time of the pCR group was significantly longer than that of the non-pCR group (92.6 vs. 69.2 months; HR, 2.70; 95% CI: 1.48-4.92; P=0.001). The 5-year OS and DFS of the pCR group were 79.3% and 77% respectively, compared to 54.8% and 51.2%, respectively, in the non-pCR group. The results showed that the OS and DFS of the ypTanyN0M0 group were better than those of the ypT0NanyM0 group and the ypTanyNanyM0 group. We also found that the number of dissected lymph nodes and pCR were independent risk factors for DFS and OS rates. CONCLUSIONS pCR after nCRT is an important prognostic indicator of OS and DFS in patients with ESCC. In addition, lymph-node status could represent an important parameter in the prognostic evaluation of esophageal cancer patients.
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Affiliation(s)
- Jianfei Shen
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Min Kong
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Hong Yang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ke Jin
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yuping Chen
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zhentao Yu
- Department of Thoracic Surgery, Tianjin Medical University Cancer Hospital, Tianjin, China
| | - Weimin Mao
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yongtao Han
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Zhijian Chen
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
- Department of Thoracic Surgery, the University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Haihua Yang
- Department of Radiotherapy, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jiaming Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Qingsong Pang
- Department of Thoracic Surgery, Tianjin Medical University Cancer Hospital, Tianjin, China
| | - Xiao Zheng
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Huanjun Yang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Tao Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, China
| | - Xu Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Qun Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Geng Wang
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Teng Mao
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xufeng Guo
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ting Lin
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Mengzhong Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Dehua Ma
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Minhua Ye
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Chunguo Wang
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Zheng Wang
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St. James’s University Hospital, Bexley Wing, Leeds, UK
| | - Robert J. Cerfolio
- Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY, USA
| | - Xavier Benoit D’Journo
- Department of Thoracic Surgery and Diseases of Esophagus, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France
| | - Hiran C. Fernando
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Florian Lordick
- University Cancer Center Leipzig, University Medicine Leipzig, Leipzig, Germany
| | - Jianhua Fu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Baofu Chen
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Chengchu Zhu
- Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Linhai, China
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
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Morton S, Grubic AD, Ayazi S, Muluk SC, Fernando HC, Jobe BA. Multifactorial dysphagia: Azygos vein aneurysm (AVA) and esophagogastric junction outflow obstruction (EGJOO). Int J Surg Case Rep 2021; 83:106017. [PMID: 34090196 PMCID: PMC8188362 DOI: 10.1016/j.ijscr.2021.106017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction Vascular impingement of the esophagus is a rare cause of dysphagia, and is most commonly due to aortic arch anomalies such as arterial lusoria. Dysphagia resultant from venous compression is even further less likely. Presentation of case We present a highly unusual case of dysphagia secondary to a large aneurysm of the azygous vein near its confluence with the superior vena cava, which was managed with endovascular modalities. Despite initial treatment success, patient reported some intermittent solid food dysphagia, and was also found to have esophagogastric junction outflow obstruction (EGJOO) on high resolution impedance manometry (HRIM) which was successfully managed with surgical myotomy and partial fundoplication. Discussion The azygos vein has an intimate anatomic relationship with the esophagus as it traverses the posterior mediastinum. Because of this anatomic association, the azygos vein may present a point of esophageal obstruction in the setting of significant pathology. Conclusion This case highlights the possibility of multifactorial causes of dysphagia, and that HRIM is a key aspect of this workup. Additionally we discuss the pertinent anatomy, diagnosis, and treatments for azygos vein aneurysm and EGJOO. Vascular impingement of the esophagus is a rare cause of dysphagia. This type of dysphagia is most commonly due to aortic arch anomalies such as arterial lusoria. The azygos vein may present a point of esophageal obstruction in the setting of significant pathology. Endovascular therapy in selected patients can provide resolution of dysphagia in patients with azygos vein aneurysm. There is possibility of multifactorial causes of dysphagia, and high resolution manometry is a key aspect of this workup.
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Affiliation(s)
- Scott Morton
- Esophageal Institute, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America
| | - Andrew D Grubic
- Esophageal Institute, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America
| | - Shahin Ayazi
- Esophageal Institute, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America.
| | - Satish C Muluk
- Division of Vascular Surgery, Department of Thoracic and Cardiovascular Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America
| | - Hiran C Fernando
- Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America
| | - Blair A Jobe
- Esophageal Institute, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, United States of America
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10
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Li Y, Shen L, Ding J, Xie D, Yang J, Zhao Y, Carretta A, Petersen RH, Gilbert S, Hida Y, Bölükbas S, Fernando HC, Jiang G, Zhu Y. Derivation and validation of a nomogram model for pulmonary thromboembolism in patients undergoing lung cancer surgery. Transl Lung Cancer Res 2021; 10:1829-1840. [PMID: 34012796 PMCID: PMC8107740 DOI: 10.21037/tlcr-21-109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background A specific risk-stratification tool is needed to facilitate safe and cost-effective approaches to the prophylaxis of acute pulmonary thromboembolism (PTE) in lung cancer surgery patients. This study aimed to develop and validate a simple nomogram model for the prediction of PTE after lung cancer surgery using readily obtainable clinical characteristics. Methods A total of 14,427 consecutive adult patients who underwent lung cancer surgery between January 2015 and July 2018 in our institution were retrospectively reviewed. Included in the cohort were 136 patients who developed PTE and 544 non-PTE patients. The patients were randomly divided into the derivation group (70%, 95 PTE patients and 380 non-PTE patients) and the validation group (30%, 41 PTE patients and 164 non-PTE patients). A nomogram model was developed based on the results of multivariate logistic analysis in the derivation group. The cut-off values were defined using Youden's index. The prognostic accuracy was measured by area under the curve (AUC) values. Results In the derivation group, multivariate logistic analysis was carried out to evaluate the risk score. The risk assessment model contained five variables: age [95% confidence interval (CI): 1.008-1.083, P=0.016], body mass index (95% CI: 1.077-1.319, P=0.001), operation time (95% CI: 1.002-1.014, P=0.008), the serum level of cancer antigen 15-3 (CA15-3) before surgery (95% CI: 1.019-1.111, P=0.005), and the abnormal results of compression venous ultrasonography before surgery (95% CI: 2.819-18.838, P<0.001). All of them were independent risk factors of PTE. To simplify the risk assessment model, a nomogram model was established, which showed a good predictive performance in the derivation group (AUC 0.792, 95% CI: 0.734-0.853) and in the validation group (AUC 0.813, 95% CI: 0.737-0.890). Conclusions A high-performance nomogram was established on the risk factors for PTE in patients undergoing lung cancer surgery. The nomogram could be used to provide an individual risk assessment and guide prophylaxis decisions for patients. Further external validation of the model is needed in lung cancer surgery patients in other clinical centers.
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Affiliation(s)
- Yuping Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junrong Ding
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanfeng Zhao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Angelo Carretta
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy
| | - René Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Yasuhiro Hida
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Servet Bölükbas
- Department of Thoracic Surgery, Kliniken Essen-Mitte, Essen, Germany
| | - Hiran C Fernando
- Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuming Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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11
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Lin YB, Fu JH, Huang Y, Hu YH, Luo KJ, Wang KX, Bella AÉ, Situ DR, Chen JY, Lin T, D’Journo XB, Novoa NM, Brunelli A, Fernando HC, Cerfolio RJ, Ismail M, Yang H. Fibrin sealant for esophageal anastomosis: A phase II study. World J Gastrointest Oncol 2020; 12:651-662. [PMID: 32699580 PMCID: PMC7340992 DOI: 10.4251/wjgo.v12.i6.651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/28/2020] [Accepted: 05/05/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Esophagectomy is a pivotal curative modality for localized esophageal or esophagogastric junction cancer (EC or EJC). Postoperative anastomotic leakage (AL) remains problematic. The use of fibrin sealant (FS) may improve the strength of esophageal anastomosis and reduce the incidence of AL.
AIM To assess the efficacy and safety of applying FS to prevent AL in patients with EC or EJC.
METHODS In this single-arm, phase II trial (Clinicaltrial.gov identifier: NCT03529266), we recruited patients aged 18-80 years with resectable EC or EJC clinically staged as T1-4aN0-3M0. An open or minimally invasive McKeown esophagectomy was performed with a circular stapled anastomosis. After performing the anastomosis, 2.5 mL of porcine FS was applied circumferentially. The primary endpoint was the proportion of patients with AL within 3 mo.
RESULTS From June 4, 2018, to December 29, 2018, 57 patients were enrolled. At the data cutoff date (June 30, 2019), three (5.3%) of the 57 patients had developed AL, including two (3.5%) with esophagogastric AL and one (1.8%) with gastric fistula. The incidence of anastomotic stricture and other major postoperative complications was 1.8% and 17.5%, respectively. The median time needed to resume oral feeding after operation was 8 d (Interquartile range: 7.0-9.0 d). No adverse events related to FS were recorded. No deaths occurred within 90 d after surgery.
CONCLUSION Perioperative sealing with porcine FS appears safe and may prevent AL after esophagectomy in patients with resectable EC or EJC. Further phase III studies are warranted.
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Affiliation(s)
- Yao-Bin Lin
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Jian-Hua Fu
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Yan Huang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Yi-Huai Hu
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Kong-Jia Luo
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Ke-Xi Wang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Amos Éla Bella
- Department of Thoracic Surgery, Avicenne Hospital, Bobigny 93000, France
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Dong-Rong Situ
- Department of Surgery, Royal Darwin Hospital, Northern Territory 0811, Australia
| | - Ji-Yang Chen
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Ting Lin
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Xavier B D’Journo
- Department of Thoracic Surgery and Diseases of Esophagus, Aix-Marseille University, Hôpital Nord, Marseille 13915, France
| | - Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca 37007, Spain
| | - Alessandro Brunelli
- Department of Thoracic Surgery, St James's University Hospital, Leeds LS9 7TF, United Kingdom
| | - Hiran C Fernando
- Section of Thoracic Surgery, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA 22042, United States
| | - Robert J Cerfolio
- Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY 10016, United States
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Academic Hospital of the Charité–Universitätsmedizin, Humboldt University Berlin, Berlin 10117, Germany
| | - Hong Yang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
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12
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Callstrom MR, Woodrum DA, Nichols FC, Palussiere J, Buy X, Suh RD, Abtin FG, Pua BB, Madoff DC, Bagla SL, Papadouris DC, Fernando HC, Dupuy DE, Healey TT, Moore WH, Bilfinger TV, Solomon SB, Yarmohammadi H, Krebs HJ, Fulp CJ, Hakime A, Tselikas L, de Baere T. Multicenter Study of Metastatic Lung Tumors Targeted by Interventional Cryoablation Evaluation (SOLSTICE). J Thorac Oncol 2020; 15:1200-1209. [PMID: 32151777 DOI: 10.1016/j.jtho.2020.02.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/14/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the safety and local recurrence-free survival in patients after cryoablation for treatment of pulmonary metastases. METHODS This multicenter, prospective, single-arm, phase 2 study included 128 patients with 224 lung metastases treated with percutaneous cryoablation, with 12 and 24 months of follow-up. The patients were enrolled on the basis of the outlined key inclusion criteria, which include one to six metastases from extrapulmonary cancers with a maximal diameter of 3.5 cm. Time to progression of the index tumor(s), metastatic disease, and overall survival rates were estimated using the Kaplan-Meier method. Complications were captured for 30 days after the procedure, and changes in performance status and quality of life were also evaluated. RESULTS Median size of metastases was 1.0 plus or minus 0.6 cm (0.2-4.5) with a median number of tumors of 1.0 plus or minus 1.2 cm (one to six). Local recurrence-free response (local tumor efficacy) of the treated tumor was 172 of 202 (85.1%) at 12 months and 139 of 180 (77.2%) at 24 months after the initial treatment. After a second cryoablation treatment for recurrent tumor, secondary local recurrence-free response (local tumor efficacy) was 184 of 202 (91.1%) at 12 months and 152 of 180 (84.4%) at 24 months. Kaplan-Meier estimates of 12- and 24-month overall survival rates were 97.6% (95% confidence interval: 92.6-99.2) and 86.6% (95% confidence interval: 78.7-91.7), respectively. Rate of pneumothorax that required pleural catheter placement was 26% (44/169). There were eight grade 3 complication events in 169 procedures (4.7%) and one (0.6%) grade 4 event. CONCLUSION Percutaneous cryoablation is a safe and effective treatment for pulmonary metastases.
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Affiliation(s)
| | | | | | - Jean Palussiere
- Department of Interventional Radiology, Institut Bergonie, Bordeaux, France
| | - Xavier Buy
- Department of Interventional Radiology, Institut Bergonie, Bordeaux, France
| | - Robert D Suh
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Fereidoun G Abtin
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, California
| | - Bradley B Pua
- Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - David C Madoff
- Department of Radiology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Sandeep L Bagla
- Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria, Virginia
| | - Dimitrios C Papadouris
- Cardiovascular and Interventional Radiology Department, Inova Alexandria Hospital, Alexandria, Virginia
| | - Hiran C Fernando
- Department of Surgery, Inova Alexandria Hospital, Alexandria, Virginia
| | - Damian E Dupuy
- Department of Diagnostic Imaging, Alpert Medical School at Brown University, Providence, Rhode Island
| | - Terrance T Healey
- Department of Diagnostic Imaging, Alpert Medical School at Brown University, Providence, Rhode Island
| | - William H Moore
- Departments of Radiology and Surgery, State University of New York at Stony Brook, University Hospital, Stony Brook, New York
| | - Thomas V Bilfinger
- Departments of Radiology and Surgery, State University of New York at Stony Brook, University Hospital, Stony Brook, New York
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Hooman Yarmohammadi
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Henry J Krebs
- Department of Radiology, Cancer Treatment Centers of America, Atlanta, Georgia
| | - Charles J Fulp
- Department of Radiology, Cancer Treatment Centers of America, Atlanta, Georgia
| | - Antoine Hakime
- Department of Interventional Radiology, Gustave Roussy-Cancer Campus, Villejuif, France
| | - Lambros Tselikas
- Department of Interventional Radiology, Gustave Roussy-Cancer Campus, Villejuif, France
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave Roussy-Cancer Campus, Villejuif, France
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13
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Ng CSH, MacDonald JK, Gilbert S, Khan AZ, Kim YT, Louie BE, Blair Marshall M, Santos RS, Scarci M, Shargal Y, Fernando HC. Expert Consensus Statement on Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer. Innovations (Phila) 2019; 14:87-89. [PMID: 31039679 DOI: 10.1177/1556984519837007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | - Young T Kim
- 5 Seoul National University Hospital, South Korea
| | - Brian E Louie
- 6 Swedish Cancer Institute and Medical Center, Seattle, Washington, USA
| | | | | | | | - Yaron Shargal
- 10 St Joseph's Healthcare, MacMaster University, Canada
| | - Hiran C Fernando
- 11 Inova Fairfax Medical Campus, Virginia Commonwealth University, Falls Church, VA, USA
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14
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Gao S, Barello S, Chen L, Chen C, Che G, Cai K, Crisci R, D'Andrilli A, Droghetti A, Fu X, Ferrari PA, Fernando HC, Ge D, Graffigna G, Huang Y, Hu J, Jiao W, Jiang G, Li X, Li H, Li S, Liu L, Ma H, Ma D, Martinez G, Maurizi G, Phan K, Qiao K, Refai M, Rendina EA, Shao G, Shen J, Tian H, Voltolini L, Vannucci J, Vanni C, Wu Q, Xu S, Yu F, Zhao S, Zhang P, Zhang L, Zhi X, Zhu C, Ng C, Sihoe ADL, Ho AMH. Clinical guidelines on perioperative management strategies for enhanced recovery after lung surgery. Transl Lung Cancer Res 2019; 8:1174-1187. [PMID: 32010595 DOI: 10.21037/tlcr.2019.12.25] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Shugeng Gao
- Department of Thoracic Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Serena Barello
- Department of Psychology, EngageMinds Hub Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Liang Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 211166, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350122, China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Kaican Cai
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Roberto Crisci
- Division of Thoracic Surgery, University of L'Aquila, Mazzini Hospital, Teramo, Italy
| | - Antonio D'Andrilli
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Droghetti
- Division of Thoracic Surgery, Carlo Poma Hospital, Mantova, Italy
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Paolo Albino Ferrari
- Division of Thoracic Surgery, A. Businco Cancer Center, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Hiran C Fernando
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Di Ge
- Department of Thoracic Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds Hub Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Yunchao Huang
- Department of Thoracic Surgery, Cancer Research Institute of Yunnan Province, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming 650106, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China
| | - Wenjie Jiao
- Division of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100032, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Haitao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Soochow 215006, China
| | - Dongchun Ma
- Department of Cardiothoracic Surgery, Anhui Chest Hospital, Hefei 230022, China
| | - Guillermo Martinez
- Department of Anesthesia and Intensive Care, Papworth Hospital, Cambridge, UK
| | - Giulio Maurizi
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Kevin Phan
- Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia
| | - Kun Qiao
- Department of Thoracic Surgery, The Third People's Hospital of Shenzhen, Shenzhen 518034, China
| | - Majed Refai
- Division of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy
| | - Erino A Rendina
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Guoguang Shao
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - Jianfei Shen
- Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China
| | - Hui Tian
- Department of Thoracic Surgery, The Qilu Hospital of Shandong University, Jinan 250012, China
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | - Jacopo Vannucci
- Department of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy
| | - Camilla Vanni
- Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Qingchen Wu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - Shidong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Song Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Peng Zhang
- Department of Cardiothoracic Surgery, Tianjing General Hospital of Tianjing Medical University, Tianjing 300052, China
| | - Lanjun Zhang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Chengchu Zhu
- Department of Thoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Wenzhou 325035, China
| | - Calvin Ng
- Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | | | - Anthony M H Ho
- Department of Anesthesiology and Perioperative Medicine, Queen's University Kingston, Ontario, Canada
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15
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Fernando HC. Potential advantage of digital drainage systems using a low-suction approach after video-assisted thoracoscopic surgery lobectomy. J Thorac Dis 2019; 11:S1923-S1924. [PMID: 31632787 DOI: 10.21037/jtd.2019.07.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiran C Fernando
- Section of Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
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16
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Sulibhavi A, Asokan S, Miller MI, Moreira P, Daly BD, Fernando HC, Litle VR, Suzuki K. Peripheral Blood Lymphocytes and Platelets Are Prognostic in Surgical pT1 Non-Small Cell Lung Cancer. Ann Thorac Surg 2019; 109:337-342. [PMID: 31593659 DOI: 10.1016/j.athoracsur.2019.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND There is a paucity of prognostic factors for patients with stage I non-small cell lung cancer (NSCLC) undergoing operations. We investigated the prognostic role of preoperative complete blood count values in patients with stage I NSCLC patients undergoing operations. METHODS A retrospective medical record review was performed of patients who underwent operations for stage I NSCLC between 2000 and 2015. Patients who died within 30 days of the operations were excluded. The primary end point was recurrence. Preoperative complete blood count values were analyzed, and a median value was used as the cutoff. Statistical analysis used χ2 and t tests along with univariate and multivariate analyses by Cox regression modeling. RESULTS The study included 103 patients. A high lymphocyte count was significantly associated with recurrence (5-year recurrence-free survival [RFS] of 69.8% for high vs 95.7% for low, P = .003), as well as high platelet (5-year RFS of 72.0% for high vs 91.8% for low, P = .02). Independent prognostic factors on multivariate analysis were high lymphocyte (hazard ratio [HR], 7.27; P = .005) and platelet counts (HR, 7.49; P = .003) as well as tumor (HR, 5.40; P = .008) and treatment characteristics (HR, 4.59; P = .01). Among patients with pT1 lesions, high lymphocyte (HR, 8.41; P = .03) and high platelet counts (HR, 19.78; P = .004) remained independent prognostic factors. Neither NLR nor PLR were significantly associated with recurrence. CONCLUSIONS In patients with pathologic stage I NSCLC undergoing surgical resection, the preoperative blood count from peripheral blood may provide prognostic value. Of significance, in patients with pT1 N0 NSCLC, high lymphocyte count and high platelet count were associated with higher recurrence.
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Affiliation(s)
| | - Sainath Asokan
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Paulo Moreira
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Benedict D Daly
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Hiran C Fernando
- Thoracic Surgery, Inova Fairfax Medical Campus, Virginia Commonwealth University, Falls Church, Virginia
| | - Virginia R Litle
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Kei Suzuki
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, Massachusetts.
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Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar AM, Ng CSH, Scarci M, Sihoe ADL, Ugalde PA, Akar FA, Bedetti B, Nadal SB, Brandolini J, Crucitti P, Enyedi A, Fernando HC, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas LA, Janik M, Juhos P, Libretti L, Lucciarini P, Macrì P, Margaritora S, Mahoozi HR, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G. Corrigendum to 'Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS)' [Eur J Cardiothorac Surg 2019;56:224-9]. Eur J Cardiothorac Surg 2019; 56:628-629. [PMID: 31436834 DOI: 10.1093/ejcts/ezz229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Diego Gonzalez-Rivas
- Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, Coruna University Hospital, Coruna, Spain
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | | | - Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Alan D L Sihoe
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai, China
| | - Paula A Ugalde
- Department of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Quebec, Canada
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel.,Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel
| | | | | | - Jury Brandolini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | | | - Attila Enyedi
- Division of Thoracic Surgery, University of Debrecen, Debrecen, Hungary
| | - Hiran C Fernando
- Department of Surgery, Fairfax Medical Campus, Falls Church, VA, USA
| | - Jozsef Furak
- Department of Surgery, University of Szeged, Szeged, Hungary
| | | | - Carlos Galvez-Munos
- Department of Thoracic Surgery, General University Hospital, Alicante, Spain
| | - Ivo Hanke
- Department of Thoracic Surgery, University Hospital Hradec Kralove, Hradec, Kralov, Czech Republic
| | - Luis A Hernandez-Arenas
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miroslav Janik
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Juhos
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Paolo Lucciarini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Paolo Macrì
- Thoracic Surgery Unit, Istituto Clinico Humanitas CCO - Catania, Catania, Italy
| | - Stefano Margaritora
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Hamid Reza Mahoozi
- Department of Thoracic Surgery, Evangelisches Krankenhaus Herne, Herne, Germany
| | - Dania Nachira
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | | | - Vadim Pischik
- Faculty of Medicine, St-Petersburg State University, Saint-Petersburg, Russia
| | - Dariusz Sagan
- Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland
| | | | | | - Laura Socci
- Thoracic Surgery Units, Sheffield Teaching Hospital, Sheffield, UK
| | - Davide Tosi
- Division of Thoracic and Transplant Surgery, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Akif Turna
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fernando Vannucci
- Department of Thoracic Surgery, Hospital Federal do Andarai, Rio de Janeiro, Brazil
| | - Marcin Zielinski
- Department of Thoracic Surgery, Pulmonary Hospital, Zakopane, Poland
| | - Gaetano Rocco
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Wu X, Fernando HC. Selecting therapy for small ground-glass tumors-the potential role of volumetric computed tomography scan. J Thorac Dis 2019; 11:S1250-S1251. [PMID: 31245100 DOI: 10.21037/jtd.2019.02.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Xiangwen Wu
- Section of Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA.,Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang 455000, China
| | - Hiran C Fernando
- Section of Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
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19
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Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar AM, Ng CSH, Scarci M, Sihoe ADL, Ugalde PA, Abu Akar F, Bedetti B, Nadal SB, Brandolini J, Crucitti P, Enyedi A, Fernando HC, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas LA, Janik M, Juhos P, Libretti L, Lucciarini P, Macrì P, Margaritora S, Mahoozi HR, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G. Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2019; 56:224-229. [DOI: 10.1093/ejcts/ezz133] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/07/2019] [Accepted: 03/20/2019] [Indexed: 01/05/2023] Open
Abstract
Abstract
OBJECTIVES
Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training.
METHODS
The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds.
RESULTS
Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be ≤4 cm. Agreement was reached on many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions.
CONCLUSIONS
The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.
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Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Diego Gonzalez-Rivas
- Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | | | - Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Alan D L Sihoe
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai, China
| | - Paula A Ugalde
- Department of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Quebec, Canada
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel
- Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel
| | | | | | - Jury Brandolini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | | | - Attila Enyedi
- Division of Thoracic Surgery, University of Debrecen, Debrecen, Hungary
| | - Hiran C Fernando
- Department of Surgery, Fairfax Medical Campus, Falls Church, VA, USA
| | - Jozsef Furak
- Department of Surgery, University of Szeged, Szeged, Hungary
| | | | - Carlos Galvez-Munos
- Department of Thoracic Surgery, General University Hospital, Alicante, Spain
| | - Ivo Hanke
- Department of Thoracic Surgery, University Hospital Hradec Kralove, Hradec, Kralov, Czech Republic
| | - Luis A Hernandez-Arenas
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miroslav Janik
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Juhos
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Paolo Lucciarini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Paolo Macrì
- Thoracic Surgery Unit, Istituto Clinico Humanitas CCO – Catania, Catania, Italy
| | - Stefano Margaritora
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | - Hamid Reza Mahoozi
- Department of Thoracic Surgery, Evangelisches Krankenhaus Herne, Herne, Germany
| | - Dania Nachira
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | | | - Vadim Pischik
- Faculty of Medicine, St-Petersburg State University, Saint-Petersburg, Russia
| | - Dariusz Sagan
- Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland
| | | | | | - Laura Socci
- Thoracic Surgery Units, Sheffield Teaching Hospital, Sheffield, UK
| | - Davide Tosi
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Akif Turna
- Division of Thoracic and Transplant Surgery, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fernando Vannucci
- Department of Thoracic Surgery, Hospital Federal do Andaraí, Rio de Janeiro, Brazil
| | - Marcin Zielinski
- Department of Thoracic Surgery, Pulmonary Hospital, Zakopane, Poland
| | - Gaetano Rocco
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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20
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Ng CS, MacDonald JK, Gilbert S, Khan AZ, Kim YT, Louie BE, Blair Marshall M, Santos RS, Scarci M, Shargal Y, Fernando HC. Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis. Innovations�(Phila) 2019; 14:90-116. [DOI: 10.1177/1556984519837027] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective Video-assisted thoracic surgery (VATS) lobectomy was introduced over 25 years ago. More recently, the technique has been modified from a multiport video-assisted thoracic surgery (mVATS) to uniportal (uVATS) and robotic (rVATS), with proponents for each approach. Additionally most lobectomies are still performed using an open approach. We sought to provide evidence-based recommendations to help define the optimal surgical approach to lobectomy for early stage non-small cell lung cancer. Methods Systematic review and meta-analysis of articles searched without limits from January 2000 to January 2018 comparing open, mVATS, uVATS, and rVATS using sources Medline, Embase, and Cochrane Library were considered for inclusion. Articles were individually scrutinized by ISMICS consensus conference members, and evidence-based statements were created and consensus processes were used to determine the ensuing recommendations. The ACC/AHA Clinical Practice Guideline Recommendation Classification system was used to assess the overall quality of evidence and the strength of recommendations. Results and recommendations One hundred and forty-five studies met the predefined inclusion criteria and were included in the meta-analysis. Comparisons were analyzed between VATS and open, and between different VATS approaches looking at oncological outcomes (survival, recurrence, lymph node evaluation), safety (adverse events), function (pain, quality of life, pulmonary function), and cost-effectiveness. Fifteen statements addressing these areas achieved consensus. The highest level of evidence suggested that mVATS is preferable to open lobectomy with lower adverse events (36% versus 42%; 88,460 patients) and less pain (IIa recommendation). Our meta-analysis suggested that overall survival was better (IIb) with mVATS compared with open (71.5% versus 66.7% 5-years; 16,200 patients). Different VATS approaches were similar for most outcomes, although uVATS may be associated with less pain and analgesic requirements (IIb). Conclusions This meta-analysis supports the role of VATS lobectomy for non-small cell lung cancer. Apart from potentially less pain and analgesic requirement with uVATS, different minimally invasive surgical approaches appear to have similar outcomes.
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Affiliation(s)
| | | | | | | | - Young T. Kim
- Seoul National University Hospital, Chongro-Ku, South Korea
| | - Brian E. Louie
- Swedish Cancer Institute and Medical Center, Seattle, WA, USA
| | | | | | | | - Yaron Shargal
- St Joseph’s Healthcare, MacMaster University, Hamilton, ON, Canada
| | - Hiran C. Fernando
- Inova Fairfax Medical Campus, Virginia Commonwealth University, Falls Church, Richmond, VA, USA
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Muñoz-Largacha JA, Rao SR, Brinckerhoff LH, Daly BD, Fernando HC, Litle VR, Suzuki K. Induction chemoradiation is associated with improved survival in chest wall invasion lung cancer. Tumori 2019; 105:331-337. [PMID: 30905273 DOI: 10.1177/0300891619839283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine if induction chemotherapy with concurrent high-dose radiation followed by resection is associated with improved survival in patients with nonsuperior sulcus lung cancer with chest wall invasion. METHODS We performed a retrospective review of clinical T3 (chest wall invasion) N0/N1 patients with non-small cell lung cancer who underwent surgical resection between January 1, 1992, and January 31, 2017. Exclusion criteria included superior sulcus tumors and resection performed for palliation/recurrence. Patients undergoing induction chemoradiation followed by surgical resection were compared to those undergoing resection first or those receiving induction radiation followed by resection. Overall survival was calculated using the Kaplan-Meier method. RESULTS Thirty-four patients were included in the analysis, with 5-year overall survival (OS) of 30%. By clinical stage, 31 (91%) were IIB (T3N0) and 3 (9%) were IIIA (T3N1). Sixteen patients (47%) received induction chemoradiation before surgery. Of the remaining 18 patients, 5 (15%) received induction radiation followed by surgery, and 13 (38%) underwent surgery as the first treatment. Three patients belonging to the group not receiving induction chemoradiation died within 30 days after surgery and were excluded from survival analysis. In the remaining 31 patients, induction chemoradiation was associated with improved 5-year OS (53% for induction chemoradiation vs 7% for others; P<0.01). Disease recurrence was evident in 9 cases, 2 (12.5%) in the induction chemoradiation group and 7 (46.6%) in the others (median disease-free time 103.0 months for induction chemoradiation group vs 8.0 months for others; P<0.01). CONCLUSION In patients with nonsuperior sulcus lung cancer with chest wall invasion, induction chemoradiation therapy followed by resection is associated with improved OS.
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Affiliation(s)
- Juan A Muñoz-Largacha
- 1 Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA
| | - Sowmya R Rao
- 2 Department of Surgery, Division of Biostatistics, Boston University School of Medicine, Boston, MA
| | - Laurence H Brinckerhoff
- 3 Department of Surgery, Division of Thoracic Surgery, Tufts University School of Medicine, Boston, MA
| | - Benedict D Daly
- 1 Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA
| | - Hiran C Fernando
- 4 Thoracic Surgery, Inova Fairfax Medical Campus, Virginia Commonwealth University, Falls Church, VA
| | - Virginia R Litle
- 1 Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA
| | - Kei Suzuki
- 1 Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA
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Affiliation(s)
- Hiran C Fernando
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
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23
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Fernando HC. Invited Commentary. Ann Thorac Surg 2018; 107:1551. [PMID: 30481512 DOI: 10.1016/j.athoracsur.2018.10.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/27/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Hiran C Fernando
- Department of Surgery, Inova Fairfax Medical Campus, 3300 Gallows Rd, NPT 2nd Flr, Falls Church, VA 22042.
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24
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Handy JR, Bremner RM, Crocenzi TS, Detterbeck FC, Fernando HC, Fidias PM, Firestone S, Johnstone CA, Lanuti M, Litle VR, Kesler KA, Mitchell JD, Pass HI, Ross HJ, Varghese TK. Expert Consensus Document on Pulmonary Metastasectomy. Ann Thorac Surg 2018; 107:631-649. [PMID: 30476477 DOI: 10.1016/j.athoracsur.2018.10.028] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 10/09/2018] [Indexed: 12/17/2022]
Affiliation(s)
- John R Handy
- Thoracic Surgery, Providence Health & Services, Portland, Oregon.
| | - Ross M Bremner
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | - Todd S Crocenzi
- Medical Oncology, Providence Cancer Center, Providence Health & Services, Portland, Oregon
| | - Frank C Detterbeck
- Section of Thoracic Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Hiran C Fernando
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia
| | - Panos M Fidias
- Medical Oncology, Center for Cancer Care, Exeter Hospital, Exeter, New Hampshire
| | | | - Candice A Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Michael Lanuti
- Division of Thoracic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Virginia R Litle
- Department of Surgery, Boston University Medical Center, Boston, Massachusetts
| | - Kenneth A Kesler
- Section of Thoracic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - John D Mitchell
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, Langone Medical Center, New York University School of Medicine, New York, New York
| | - Helen J Ross
- Division of Hematology/Medical Oncology, Mayo Clinic, Phoenix, Arizona
| | - Thomas K Varghese
- Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah
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25
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Mayor MA, Khandhar SJ, Chandy J, Fernando HC. Implementing a thoracic enhanced recovery with ambulation after surgery program: key aspects and challenges. J Thorac Dis 2018; 10:S3809-S3814. [PMID: 30505568 DOI: 10.21037/jtd.2018.10.106] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Enhanced recovery after surgery (ERAS) protocols aim to improve operative outcomes by focusing on perioperative care, including early mobilization, limitation of narcotics, and maintenance of fluid balance. We implemented a T-ERAAS (Thoracic-Early Recovery with Ambulation After Surgery) protocol which focused on early ambulation, with the rationale that a patient's mobility may be a reproducible and measurable metric for their overall status-pain control, respiratory function, cardiac function, and patient satisfaction. We set a benchmark distance of 250 feet for our early ambulation goal and redefined "early" as within the first hour post extubation. We describe some of the major aspects to our program as well as some of the challenges and successes during our 8-year experience following the implementation of this program.
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Affiliation(s)
- Marissa A Mayor
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Sandeep J Khandhar
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Joby Chandy
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Hiran C Fernando
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
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Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, Mao W, Xiang J, Han Y, Chen Z, Yang H, Wang J, Pang Q, Zheng X, Yang H, Li T, Lordick F, D’Journo XB, Cerfolio RJ, Korst RJ, Novoa NM, Swanson SJ, Brunelli A, Ismail M, Fernando HC, Zhang X, Li Q, Wang G, Chen B, Mao T, Kong M, Guo X, Lin T, Liu M, Fu J. Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial. J Clin Oncol 2018; 36:2796-2803. [PMID: 30089078 PMCID: PMC6145832 DOI: 10.1200/jco.2018.79.1483+] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose The efficacy of neoadjuvant chemoradiotherapy (NCRT) plus surgery for locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In this trial, we compared the survival and safety of NCRT plus surgery with surgery alone in patients with locally advanced ESCC. Patients and Methods From June 2007 to December 2014, 451 patients with potentially resectable thoracic ESCC, clinically staged as T1-4N1M0/T4N0M0, were randomly allocated to NCRT plus surgery (group CRT; n = 224) and surgery alone (group S; n = 227). In group CRT, patients received vinorelbine 25 mg/m2 intravenously (IV) on days 1 and 8 and cisplatin 75 mg/m2 IV day 1, or 25 mg/m2 IV on days 1 to 4 every 3 weeks for two cycles, with a total concurrent radiation dose of 40.0 Gy administered in 20 fractions of 2.0 Gy on 5 days per week. In both groups, patients underwent McKeown or Ivor Lewis esophagectomy. The primary end point was overall survival. Results The pathologic complete response rate was 43.2% in group CRT. Compared with group S, group CRT had a higher R0 resection rate (98.4% v 91.2%; P = .002), a better median overall survival (100.1 months v 66.5 months; hazard ratio, 0.71; 95% CI, 0.53 to 0.96; P = .025), and a prolonged disease-free survival (100.1 months v 41.7 months; hazard ratio, 0.58; 95% CI, 0.43 to 0.78; P < .001). Leukopenia (48.9%) and neutropenia (45.7%) were the most common grade 3 or 4 adverse events during chemoradiotherapy. Incidences of postoperative complications were similar between groups, with the exception of arrhythmia (group CRT: 13% v group S: 4.0%; P = .001). Peritreatment mortality was 2.2% in group CRT versus 0.4% in group S ( P = .212). Conclusion This trial shows that NCRT plus surgery improves survival over surgery alone among patients with locally advanced ESCC, with acceptable and manageable adverse events.
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Affiliation(s)
- Hong Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Hui Liu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Yuping Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Chengchu Zhu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Wentao Fang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Zhentao Yu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Weimin Mao
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jiaqing Xiang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Yongtao Han
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Zhijian Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Haihua Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jiaming Wang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Qingsong Pang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xiao Zheng
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Huanjun Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Tao Li
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Florian Lordick
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xavier Benoit D’Journo
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Robert J. Cerfolio
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Robert J. Korst
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Nuria M. Novoa
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Scott J. Swanson
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Alessandro Brunelli
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Mahmoud Ismail
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Hiran C. Fernando
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xu Zhang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Qun Li
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Geng Wang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Baofu Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Teng Mao
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Min Kong
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xufeng Guo
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Ting Lin
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Mengzhong Liu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jianhua Fu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
- Corresponding author: Jianhua Fu, MD, PhD, Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou City, Guangdong Province, 510060, China; e-mail:
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Yang H, Liu H, Chen Y, Zhu C, Fang W, Yu Z, Mao W, Xiang J, Han Y, Chen Z, Yang H, Wang J, Pang Q, Zheng X, Yang H, Li T, Lordick F, D’Journo XB, Cerfolio RJ, Korst RJ, Novoa NM, Swanson SJ, Brunelli A, Ismail M, Fernando HC, Zhang X, Li Q, Wang G, Chen B, Mao T, Kong M, Guo X, Lin T, Liu M, Fu J. Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Surgery Alone for Locally Advanced Squamous Cell Carcinoma of the Esophagus (NEOCRTEC5010): A Phase III Multicenter, Randomized, Open-Label Clinical Trial. J Clin Oncol 2018; 36:2796-2803. [PMID: 30089078 PMCID: PMC6145832 DOI: 10.1200/jco.2018.79.1483] [Citation(s) in RCA: 505] [Impact Index Per Article: 84.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose The efficacy of neoadjuvant chemoradiotherapy (NCRT) plus surgery for locally advanced esophageal squamous cell carcinoma (ESCC) remains controversial. In this trial, we compared the survival and safety of NCRT plus surgery with surgery alone in patients with locally advanced ESCC. Patients and Methods From June 2007 to December 2014, 451 patients with potentially resectable thoracic ESCC, clinically staged as T1-4N1M0/T4N0M0, were randomly allocated to NCRT plus surgery (group CRT; n = 224) and surgery alone (group S; n = 227). In group CRT, patients received vinorelbine 25 mg/m2 intravenously (IV) on days 1 and 8 and cisplatin 75 mg/m2 IV day 1, or 25 mg/m2 IV on days 1 to 4 every 3 weeks for two cycles, with a total concurrent radiation dose of 40.0 Gy administered in 20 fractions of 2.0 Gy on 5 days per week. In both groups, patients underwent McKeown or Ivor Lewis esophagectomy. The primary end point was overall survival. Results The pathologic complete response rate was 43.2% in group CRT. Compared with group S, group CRT had a higher R0 resection rate (98.4% v 91.2%; P = .002), a better median overall survival (100.1 months v 66.5 months; hazard ratio, 0.71; 95% CI, 0.53 to 0.96; P = .025), and a prolonged disease-free survival (100.1 months v 41.7 months; hazard ratio, 0.58; 95% CI, 0.43 to 0.78; P < .001). Leukopenia (48.9%) and neutropenia (45.7%) were the most common grade 3 or 4 adverse events during chemoradiotherapy. Incidences of postoperative complications were similar between groups, with the exception of arrhythmia (group CRT: 13% v group S: 4.0%; P = .001). Peritreatment mortality was 2.2% in group CRT versus 0.4% in group S ( P = .212). Conclusion This trial shows that NCRT plus surgery improves survival over surgery alone among patients with locally advanced ESCC, with acceptable and manageable adverse events.
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Affiliation(s)
- Hong Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Hui Liu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Yuping Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Chengchu Zhu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Wentao Fang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Zhentao Yu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Weimin Mao
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jiaqing Xiang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Yongtao Han
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Zhijian Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Haihua Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jiaming Wang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Qingsong Pang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xiao Zheng
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Huanjun Yang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Tao Li
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Florian Lordick
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xavier Benoit D’Journo
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Robert J. Cerfolio
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Robert J. Korst
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Nuria M. Novoa
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Scott J. Swanson
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Alessandro Brunelli
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Mahmoud Ismail
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Hiran C. Fernando
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xu Zhang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Qun Li
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Geng Wang
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Baofu Chen
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Teng Mao
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Min Kong
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Xufeng Guo
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Ting Lin
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Mengzhong Liu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
| | - Jianhua Fu
- Hong Yang, Hui Liu, Xu Zhang, Qun Li, Ting Lin, Mengzhong Liu, and Jianhua Fu, Sun Yat-sen University Cancer Center, Guangzhou; Yuping Chen, Zhijian Chen, and Geng Wang, Cancer Hospital of Shantou University Medical College, Shantou; Zhijian Chen, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province; Chengchu Zhu, Haihua Yang, Baofu Chen, and Min Kong, Taizhou Hospital, Wenzhou Medical University, Linhai; Weimin Mao and Xiao Zheng, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province; Wentao Fang, Jiaming Wang, Teng Mao, and Xufeng Guo, Shanghai Chest Hospital, Shanghai Jiaotong University; Jiaqing Xiang and Huanjun Yang, Fudan University Shanghai Cancer Center, Shanghai; Zhentao Yu and Qingsong Pang, Tianjin Medical University Cancer Hospital, Tianjin; Yongtao Han and Tao Li, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China; Florian Lordick, University Cancer Center Leipzig, University Medicine Leipzig, Leipzig; Mahmoud Ismail, Academic Hospital of the Charité – Universitätsmedizin, Humboldt University Berlin, Berlin, Germany; Xavier Benoit D’Journo, Aix-Marseille University, Hôpital Nord, Chemin des Bourrely, Marseille Cedex, France; Robert J. Cerfolio, New York University Langone Health; Robert J. Korst, Icahn School of Medicine, Mount Sinai Health System, New York, NY; Robert J. Korst, Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Nuria M. Novoa, University Hospital of Salamanca, Paseo de San Vicente, Salamanca, Spain; Scott J. Swanson, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; Alessandro Brunelli, St James's University Hospital, Leeds, United Kingdom; and Hiran C. Fernando, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA
- Corresponding author: Jianhua Fu, MD, PhD, Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou City, Guangdong Province, 510060, China; e-mail:
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Li X, Su X, Chen B, Yao H, Yu Y, Leng X, Lu Q, Wang C, Lei J, Ruetzler K, Fernando HC, Gilbert S, Yeung C, Filosso PL, Shen J, Zhu C. Multidisciplinary team approach on a case of bilateral tension pneumothorax. J Thorac Dis 2018; 10:2528-2536. [PMID: 29850161 DOI: 10.21037/jtd.2018.04.81] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaodong Li
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 318000, China
| | - Xiaofen Su
- Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China
| | - Baofu Chen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 318000, China.,School of Medicine, Shandong University, Jinan 250100, China
| | - Haijun Yao
- Intensive Care Unit, the Sixth People's Hospital of Shanghai Jiao Tong University, Shanghai 200233, China
| | - Yuetian Yu
- Intensive Care Unit, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Xuefeng Leng
- Department of Thoracic Surgery, the Affiliated Hospital of Chengdu University, Chengdu 610081, China
| | - Qiang Lu
- Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710032, China
| | - Chunguang Wang
- Department of Anesthesiology, Baoding First Central Hospital, Baoding 071028, China
| | - Juanjuan Lei
- Department of Rehabilitation, Tangdu Hospital, the Fourth Military Medical University, Xi'an 710032, China
| | - Kurt Ruetzler
- Departments of Outcomes Research and General Anesthesiology, Cleveland Clinic, Main Campus, Cleveland, OH, USA
| | - Hiran C Fernando
- Inova Schar Cancer Institute, Inova Fairfax Medical Campus, Section of Thoracic Surgery, Department of Surgery 3300 Gallows Road, Falls Church, VA, USA
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Canada
| | - Ching Yeung
- Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Canada
| | | | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 318000, China
| | - Chengchu Zhu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 318000, China
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Fernando HC, Yang J, Ferraro GL, Keller SM. Randomized, double-blind phase 3 study evaluating neoadjuvant platinum-based chemotherapy with perioperative pembrolizumab or placebo in resectable stage IIB or IIIA NSCLC: KEYNOTE-671. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.tps8583] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hiran C. Fernando
- Department of Surgery and Department of Thoracic Oncology, INOVA Fairfax Medical Campus, Falls Church, VA
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Khandhar SJ, Schatz CL, Collins DT, Graling PR, Rosner CM, Mahajan AK, Kiernan PD, Liu C, Fernando HC. Thoracic enhanced recovery with ambulation after surgery: a 6-year experience. Eur J Cardiothorac Surg 2018; 53:1192-1198. [DOI: 10.1093/ejcts/ezy061] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/23/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandeep J Khandhar
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Christy L Schatz
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Devon T Collins
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Paula R Graling
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Carolyn M Rosner
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Amit K Mahajan
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Paul D Kiernan
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Chang Liu
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Hiran C Fernando
- Inova Cardiac and Thoracic Surgery, Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
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Narsule CK, Sridhar P, Nair D, Gupta A, Oommen RG, Ebright MI, Litle VR, Fernando HC. Percutaneous thermal ablation for stage IA non-small cell lung cancer: long-term follow-up. J Thorac Dis 2017; 9:4039-4045. [PMID: 29268414 DOI: 10.21037/jtd.2017.08.142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Surgical resection is the most effective curative therapy for non-small cell lung cancer (NSCLC). However, many patients are unable to tolerate resection secondary to poor reserve or comorbid disease. Radiofrequency ablation (RFA) and microwave ablation (MWA) are methods of percutaneous thermal ablation that can be used to treat medically inoperable patients with NSCLC. We present long-term outcomes following thermal ablation of stage IA NSCLC from a single center. Methods Patients with stage IA NSCLC and factors precluding resection who underwent RFA or MWA from July 2005 to September 2009 were studied. CT and PET-CT scans were performed at 3 and 6 month intervals, respectively, for first 24 months of follow-up. Factors associated with local progression (LP) and overall survival (OS) were analyzed. Results Twenty-one patients underwent 21 RFA and 4 MWA for a total of 25 ablations. Fifteen patients had T1a and six patients had T1b tumors. Mean follow-up was 42 months, median survival was 39 months, and OS at three years was 52%. There was no significant difference in median survival between T1a nodules and T1b nodules (36 vs. 39 months, P=0.29) or for RFA and MWA (36 vs. 50 months, P=0.80). Ten patients had LP (47.6%), at a median time of 35 months. There was no significant difference in LP between T1a and T1b tumors (22 vs. 35 months, P=0.94) or RFA and MWA (35 vs. 17 months, P=0.18). Median OS with LP was 32 months compared to 39 months without LP (P=0.68). Three patients underwent repeat ablations. Mean time to LP following repeat ablation was 14.75 months. One patient had two repeat ablations and was disease free at 40-month follow-up. Conclusions Thermal ablation effectively treated or controlled stage IA NSCLC in medically inoperable patients. Three-year OS exceeded 50%, and LP did not affect OS. Therefore, thermal ablation is a viable option for medically inoperable patients with early stage NSCLC.
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Affiliation(s)
- Chaitan K Narsule
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Praveen Sridhar
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Divya Nair
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Avneesh Gupta
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - Roy G Oommen
- Department of Surgery, Columbia University, NewYork-Presbytarian/Lawrence Hospital Center, Bronxville, NY, USA
| | - Michael I Ebright
- Section of Thoracic Surgery, Columbia University Medical Center, New York, NY, USA
| | - Virginia R Litle
- Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Hiran C Fernando
- Division of Thoracic Surgery, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA, USA
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Abstract
Gastroesophageal reflux disease (GERD) is a common condition that places a significant burden on the healthcare system. Additionally, there have been concerns raised about potential risks of long-term proton pump inhibitors. Laparoscopic anti-reflux surgery is currently the gold standard option for patients when surgery is planned. However, there continues to be interest in an endoscopic, alternative to laparoscopic surgery. Transoral incisionless fundoplication (TIF) is being increasingly utilized for such patients. We review the indications, patient selection and technique for this procedure. A video of the procedure, which we previously published on CTSNet is also attached.
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Affiliation(s)
- Hiran C Fernando
- Inova Schar Cancer Institute, Inova Fairfax Medical Campus, Falls Church, Virginia, VA, USA
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Muñoz-Largacha JA, Gower AC, Sridhar P, Deshpande A, O'Hara CJ, Yamada E, Godfrey TE, Fernando HC, Litle VR. miRNA profiling of primary lung and head and neck squamous cell carcinomas: Addressing a diagnostic dilemma. J Thorac Cardiovasc Surg 2017; 154:714-727. [DOI: 10.1016/j.jtcvs.2017.02.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 01/31/2017] [Accepted: 02/25/2017] [Indexed: 12/12/2022]
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Ebright MI, Sridhar P, Litle VR, Narsule CK, Daly BD, Fernando HC. Endoscopic Fundoplication. Innovations 2017. [DOI: 10.1177/155698451701200303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michael I. Ebright
- Section of Thoracic Surgery, Columbia University Medical Center, New York, NY USA
| | - Praveen Sridhar
- Division of Thoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Virginia R. Litle
- Division of Thoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Chaitan K. Narsule
- Division of Thoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Benedict D. Daly
- Division of Thoracic Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Hiran C. Fernando
- Section of Thoracic Surgery, Inova Fairfax Hospital, Fairfax, VA USA
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Abstract
Lung cancer continues to be the most common cause of cancer death. Screening programs for high risk patients with the use of low-dose computed tomography (CT) has led to the identification of small lung lesions that were difficult to identify using previous imaging modalities. Electromagnetic navigational bronchoscopy (ENB) is a novel technique that has shown to be of great utility during the evaluation of small, peripheral lesions, that would otherwise be challenging to evaluate with conventional bronchoscopy. The diagnostic yield of navigational bronchoscopy however is highly variable, with reports ranging from 59% to 94%. This variability suggests that well-defined selection criteria and standardized protocols for the use of ENB are lacking. Despite this variability, we believe that this technique is a useful tool evaluating small peripheral lung lesions when patients are properly selected.
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Affiliation(s)
- Juan A Muñoz-Largacha
- Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Virginia R Litle
- Department of Surgery, Division of Thoracic Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Hiran C Fernando
- Inova Schar Cancer Institute, Inova Fairfax Medical Campus, Falls Church, VA, USA
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Abstract
The incidence of Barrett's esophagus (BE) in the Western world has increased over the last decades. BE is considered a premalignant lesion that can progress to esophageal adenocarcinoma (EAC), a highly aggressive malignancy with poor survival rates. The close association between BE and EAC highlights the need for an early diagnosis in order to improve survival and outcomes in this group of patients. Although the evidence for BE screening with conventional endoscopy is controversial and limited by cost-effectiveness studies, screening can be suggested in patients with chronic gastroesophageal reflux disease (GERD) and two or more risk factors for EAC. Less invasive techniques with lower costs and higher acceptability by the patients may be useful for screening in the general population. Several novel techniques have been described to aid in the early diagnosis and management of BE and dysplasia. However, these techniques have shown variable results with higher costs, the need of specific training, and variable inter-observer imaging interpretation, making its widespread implementation problematic. High-definition/high-resolution white-light endoscopy (WLE) continues to be a well-accepted technique for the evaluation and surveillance of patients with BE. Further studies are required in order to establish the efficacy of less invasive methods that can be performed in an outpatient setting for BE screening in higher risk individuals.
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Affiliation(s)
- Juan A Muñoz-Largacha
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Hiran C Fernando
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, USA
| | - Virginia R Litle
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, USA
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Muñoz-Largacha JA, Ebright MI, Litle VR, Fernando HC. Electromagnetic navigational bronchoscopy with dye marking for identification of small peripheral lung nodules during minimally invasive surgical resection. J Thorac Dis 2017; 9:802-808. [PMID: 28449489 DOI: 10.21037/jtd.2017.03.18] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Identification of small peripheral lung nodules during minimally invasive resection can be challenging. Electromagnetic navigational bronchoscopy (ENB) with injection of dye to identify nodules can be performed by the surgeon immediately prior to resection. We evaluated the effectiveness of ENB with dye marking to aid minimally invasive resection. METHODS Patients with peripheral pulmonary nodules underwent ENB before planned thoracoscopic or robotic-assisted thoracoscopic resection. Methylene blue was injected directly into the lesion for pleural-based lesions or peripherally for lesions deep to the pleural surface. Surgical resection was then immediately performed. Technical success was defined as identification of the dye marking within/close to the lesion with pathological confirmation after minimally invasive surgical resection. RESULTS Seventeen patients (19 nodules) underwent ENB with dye marking followed by minimally invasive resection. Median lesion size was 9 mm (4-32 mm) and the median distance from the pleura was 9.5 mm (1-40 mm). Overall success rate was 79% (15/19). In two cases the dye was not visualized and in the remaining two there was extravasation of dye into the pleural space. There were trends favoring technical success for nodules that were larger or closer to the pleural surface. Five patients required adhesiolysis to visualize the target lesion and all were successful. There were no significant adverse events and a definitive diagnosis was ultimately accomplished in all patients. CONCLUSIONS ENB with dye marking is useful for guiding minimally invasive resection of small peripheral lung nodules. ENB can be undertaken immediately before performing resection in the operating room. This improves workflow and avoids the need for a separate localization procedure.
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Affiliation(s)
- Juan A Muñoz-Largacha
- Boston University School of Medicine, Department of Surgery, Division of Thoracic Surgery, Boston, MA, USA
| | - Michael I Ebright
- Columbia University Medical Center, Department of Surgery, Division of Thoracic Surgery, New York, NY, USA
| | - Virginia R Litle
- Boston University School of Medicine, Department of Surgery, Division of Thoracic Surgery, Boston, MA, USA
| | - Hiran C Fernando
- Section of Thoracic Surgery, Inova Fairfax Medical Center, Inova Schar Cancer Institute, Falls Church, VA, USA
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Fernando HC. Preface to Uniportal VATS Journey. Video-assist Thorac Surg 2016. [DOI: 10.21037/vats.2016.08.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hachey KJ, Sterbling H, Choi DS, Pinjic E, Hewes PD, Munoz J, McAneny D, Tripodis Y, Fernando HC, Litle VR. Prevention of Postoperative Venous Thromboembolism in Thoracic Surgical Patients: Implementation and Evaluation of a Caprini Risk Assessment Protocol. J Am Coll Surg 2016; 222:1019-27. [DOI: 10.1016/j.jamcollsurg.2015.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 11/23/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
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Muñoz-Largacha JA, O’Hara CJ, Sloan JM, Fernando HC, Litle VR. Surgical Management of Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma Associated With Light-Chain Deposition Disease. Ann Thorac Surg 2016; 101:e207-10. [DOI: 10.1016/j.athoracsur.2015.10.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/14/2015] [Accepted: 10/26/2015] [Indexed: 11/25/2022]
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Kent MS, Mandrekar SJ, Landreneau R, Nichols F, DiPetrillo TA, Meyers B, Heron DE, Jones DR, Tan AD, Starnes S, Putnam JB, Fernando HC. Impact of Sublobar Resection on Pulmonary Function: Long-Term Results from American College of Surgeons Oncology Group Z4032 (Alliance). Ann Thorac Surg 2016; 102:230-8. [PMID: 27101728 DOI: 10.1016/j.athoracsur.2016.01.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/04/2016] [Accepted: 01/06/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sublobar resection (SR) in high-risk operable patients may result in a long-term decrease in pulmonary function. We previously reported 3-month pulmonary function outcomes from a randomized phase III study of SR alone compared with SR with brachytherapy in patients with non-small cell lung cancer. We now report long-term pulmonary function after SR. METHODS Pulmonary function was measured at baseline and at 3, 12, and 24 months. A decline of 10% or more from baseline in the percentage predicted forced expiratory volume of 1 percentage or in the diffusion capacity of the lung for carbon monoxide was considered clinically meaningful. The effect of study arm, tumor location, size, approach (video-assisted thoracoscopic surgery vs thoracotomy), and SR type (wedge vs segmentectomy) on pulmonary function was assessed using a Wilcoxon rank sum test. A generalized estimating equation model was used to assess the effect of each factor on longitudinal data, including all four time points. RESULTS Complete pulmonary function data at all time points was available in 69 patients. No significant differences were observed in pulmonary function between SR and SR with brachytherapy, thus the study arms were combined for all analyses. A decline of 10% or more (p = 0.02) in the percentage predicted forced expiratory volume in 1 second was demonstrated for lower-lobe resections at 3 months but was not at 12 or 24 months. A decline of 10% or more (p = 0.05) in the percentage predicted diffusion capacity of the lung for carbon monoxide was seen for thoracotomy at 3 months but was not at 12 or 24 months. CONCLUSIONS Clinically meaningful declines in pulmonary function occurred after lower lobe resection and after thoracotomy at 3 months but subsequently recovered. This study suggests that SR does not result in sustained decreased pulmonary function in high-risk operable patients.
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Affiliation(s)
- Michael S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Sumithra J Mandrekar
- Department of Health Sciences Research, Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Rodney Landreneau
- Department of Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | | | - Thomas A DiPetrillo
- Department of Radiation Oncology, Rhode Island Hospital, Providence, Rhode Island
| | - Bryan Meyers
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Dwight E Heron
- Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - David R Jones
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Angelina D Tan
- Department of Health Sciences Research, Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Sandra Starnes
- Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Joe B Putnam
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hiran C Fernando
- Department of Surgery, Boston Medical Center, Boston, Massachusetts
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Fernando HC, Dupuy DE. Reply to defining the role of radiofrequency ablation and stereotactic ablative radiotherapy in patients with high-risk, early-stage non-small cell lung cancer. Cancer 2016; 122:323-4. [PMID: 26421899 DOI: 10.1002/cncr.29699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Hiran C Fernando
- Department of Thoracic Surgery, Boston University Medical Center, Boston, Massachusetts
| | - Damian E Dupuy
- Department of Diagnostic Imaging, Rhode Island Hospital, Providence, Rhode Island
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Hachey KJ, Hewes PD, Porter LP, Ridyard DG, Rosenkranz P, McAneny D, Fernando HC, Litle VR. Caprini venous thromboembolism risk assessment permits selection for postdischarge prophylactic anticoagulation in patients with resectable lung cancer. J Thorac Cardiovasc Surg 2016; 151:37-44.e1. [DOI: 10.1016/j.jtcvs.2015.08.039] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/31/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
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Hewes PD, Hachey KJ, Zhang XW, Tripodis Y, Rosenkranz P, Ebright MI, McAneny D, Fernando HC, Litle VR. Evaluation of the Caprini Model for Venothromboembolism in Esophagectomy Patients. Ann Thorac Surg 2015; 100:2072-8. [DOI: 10.1016/j.athoracsur.2015.05.098] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/11/2015] [Accepted: 05/26/2015] [Indexed: 11/30/2022]
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dos Santos RS, Franceschini JP, Chate RC, Ghefter MC, Kay F, Trajano ALC, Pereira JR, Succi JE, Fernando HC, Júnior RS. Do Current Lung Cancer Screening Guidelines Apply for Populations With High Prevalence of Granulomatous Disease? Results From the First Brazilian Lung Cancer Screening Trial (BRELT1). Ann Thorac Surg 2015; 101:481-6; discussion 487-8. [PMID: 26409711 DOI: 10.1016/j.athoracsur.2015.07.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 05/25/2015] [Accepted: 07/09/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Low-dose computed tomography (LDCT) screening for lung cancer has been demonstrated to be effective in reducing cancer mortality. However, these studies have not been undertaken in countries where the incidence of granulomatous disease is high. The First Brazilian Lung Cancer Screening Trial (BRELT1) has completed initial accrual and is now in the follow-up phase. We present results from the initial prevalence round of screening. METHODS The inclusion criteria were the same as those for the National Lung Cancer Screening Trial (NLST). Pulmonary nodules larger than 4 mm were considered positive and required evaluation by a multidisciplinary team. Indeterminate nodules were evaluated with fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) or biopsy when indicated. Statistical analysis was performed with Fisher's exact test to compare our positive findings with those of the NLST. RESULTS From January 2013 to July 2014, 790 participants were enrolled. Positive LDCT scans were reported in 312 (39.4%) participants, with a total of 552 nodules larger than 4 mm. The comparison between positive findings in the NLST (7,191 of 26,722 cases) and those in the BRELT1 (312 of 790 cases) showed a significant difference (p < 0.001). The positive predictive value was lower in BRELT1 than in the NLST (3.2% versus 3.8%, respectively). Follow-up imaging was indicated in 278 of 312 (89.1%) participants; 35 procedures were performed in 25 participants. In 15 cases, benign lesions were diagnosed. Non-small-cell lung cancer (NSCLC) was diagnosed in 10 patients (prevalence of 1.3%). In 8 patients (stage IA/IB disease), treatment was by resection only, in 1 patient neoadjuvant chemotherapy was used (stage IIIA), and in 1 patient advanced disease was diagnosed (stage IV). CONCLUSIONS Using NSLT criteria, a larger number of patients had positive scans (nodules), compared with previous lung cancer screening studies. However, the number of participants requiring surgical biopsy procedures and who were ultimately identified as having cancer was similar to other reports. This supports the role of screening in patient populations with a high incidence of granulomatous inflammation.
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Affiliation(s)
- Ricardo Sales dos Santos
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil.
| | - Juliana P Franceschini
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo Caruso Chate
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Fernando Kay
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - André Luiz C Trajano
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Instituto Cardiopulmonar da Bahia, Salvador, Brazil
| | | | - José Ernesto Succi
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Universidade Federal de São Paulo, São Paulo, Brazil
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Dupuy DE, Fernando HC, Hillman S, Ng T, Tan AD, Sharma A, Rilling WS, Hong K, Putnam JB. Radiofrequency ablation of stage IA non-small cell lung cancer in medically inoperable patients: Results from the American College of Surgeons Oncology Group Z4033 (Alliance) trial. Cancer 2015; 121:3491-8. [PMID: 26096694 DOI: 10.1002/cncr.29507] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/08/2015] [Accepted: 04/14/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND This study evaluated the 2-year overall survival rate, adverse event rate, local control rate, and impact on pulmonary function tests for medically inoperable patients with stage IA non-small cell lung cancer (NSCLC) undergoing computed tomography (CT)-guided radiofrequency ablation (RFA) in a prospective, multicenter trial. METHODS Fifty-four patients (25 men and 29 women) with a median age of 76 years (range, 60-89 years) were enrolled from 16 US centers; 51 patients were eligible for evaluation (they had biopsy-proven stage IA NSCLC and were deemed medically inoperable by a board-certified thoracic surgeon). Pulmonary function tests were performed within the 60 days before RFA and 3 and 24 months after RFA. Adverse events were recorded and categorized. Patients were followed with CT and fludeoxyglucose positron emission tomography. Local control rate and recurrence patterns were analyzed. RESULTS The overall survival rate was 86.3% at 1 year and 69.8% at 2 years. The local tumor recurrence-free rate was 68.9% at 1 year and 59.8% at 2 years and was worse for tumors > 2 cm. In the 19 patients with local recurrence, 11 were re-treated with RFA, 9 underwent radiation, and 3 underwent chemotherapy. There were 21 grade 3 adverse events, 2 grade 4 adverse events, and 1 grade 5 adverse event in 12 patients within the first 90 days after RFA. None of the grade 4 or 5 adverse events were attributable to RFA. There was no significant change in the forced expiratory volume in the first second of expiration or the diffusing capacity of lung for carbon monoxide after RFA. A tumor size less than 2.0 cm and a performance status of 0 or 1 were associated with statistically significant improved survival of 83% and 78%, respectively, at 2 years. CONCLUSIONS RFA is a single, minimally invasive procedure that is well tolerated in medically inoperable patients, does not adversely affect pulmonary function tests, and provides a 2-year overall survival rate that is comparable to the rate reported after stereotactic body radiotherapy in similar patients.
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Affiliation(s)
- Damian E Dupuy
- Rhode Island Hospital/Alpert Medical School, Brown University, Providence, Rhode Island
| | - Hiran C Fernando
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Shauna Hillman
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Thomas Ng
- Rhode Island Hospital/Alpert Medical School, Brown University, Providence, Rhode Island
| | - Angelina D Tan
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Amita Sharma
- Radiological Associates, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Kelvin Hong
- Johns Hopkins Medical Center, Johns Hopkins Hospital, Baltimore, Maryland
| | - Joe B Putnam
- Vanderbilt University Medical Center, Vanderbilt Clinic, Nashville, Tennessee
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Fernando HC, Landreneau RJ, Mandrekar SJ, Nichols FC, DiPetrillo TA, Meyers BF, Heron DE, Hillman SL, Jones DR, Starnes SL, Tan AD, Daly BDT, Putnam JB. Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer: results from the ACOSOG Z4032 (Alliance) multicenter randomized trial. J Thorac Cardiovasc Surg 2014; 149:718-25; discussion 725-6. [PMID: 25500100 DOI: 10.1016/j.jtcvs.2014.11.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 09/10/2014] [Accepted: 11/04/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Prior studies have suggested that low baseline quality-of-life (QOL) scores predict worse survival in patients undergoing lung cancer surgery. However, these studies involved average-risk patients undergoing lobectomy. We report QOL results from a multicenter trial, American College of Surgeons Oncology Group Z4032, which randomized high-risk operable patients to sublobar resection (SR), or SR with brachytherapy, and included longitudinal QOL assessments. METHODS Global QOL, using the 36-item Short-Form Health Survey (SF36), and the dyspnea score from the University of California, San Diego Shortness of Breath Questionnaire (SOBQ) scale, was measured at baseline, 3, 12, and 24 months. SF36 physical component summary (PCS) and mental component summary (MCS) scores were standardized and adjusted for age and gender normals, with scores <50 indicating below-average health status. SOBQ scores were transformed to a 0-100 (poor-excellent) scale. Aims were to: (1) determine the impact of baseline scores on recurrence-free survival, overall survival, and 30-day adverse events (AEs); and (2) identify subgroups (surgical approach, resection type. tumor location, tumor size, respiratory function) with a ≥ 10-point decline or improvement in QOL after SR. RESULTS Two hundred twelve eligible patients were included. There were no significant differences in baseline QOL scores between arms. Median baseline PCS, MCS, and SOBQ scores were 42.7, 51.1, and 70.8, respectively. There were no differences in grade-3+ AEs, overall survival, or recurrence-free survival in patients with baseline scores ≤ median versus > median values, except for a significantly worse overall survival for patients with baseline SOBQ scores ≤ median value. There were no significant differences between the study arms in percentage change of QOL scores from baseline to 3, 12, or 24 months. Further comparison combining the 2 arms demonstrated a higher percentage of patients with a ≥ 10-point decline in SOBQ scores with segmentectomy compared with wedge resection (40.5% vs 21.9%, P = .03) at 12 months, with thoracotomy versus video-assisted thoracic surgery (VATS) (38.8% vs 20.4%, P = .03) at 12 months, and T1b versus T1a tumors (46.9% vs 23.5%, P = .020) at 24 months. A ≥ 10-point improvement in PCS score was seen at 3 months with VATS versus thoracotomy (16.5% vs 3.6%, P = .02). CONCLUSIONS In high-risk operable patients, poor baseline QOL scores were not predictive for worse overall or recurrence-free survival, or for higher risk for AEs following SR. VATS was associated with improvement in physical function at 3 months, and improved dyspnea scores at 12 months, lending support for the preferential use of VATS when SR is undertaken.
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Affiliation(s)
| | | | | | | | | | | | | | - Shauna L Hillman
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minn
| | | | | | - Angelina D Tan
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minn
| | | | - Joe B Putnam
- Vanderbilt University Medical Center, Nashville, Tenn
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Sridhar P, Steenkamp DW, Lee SL, Ebright MI, Litle VR, Fernando HC. Mediastinal Parathyroid Adenoma with Osteitis Fibrosis Cystica: Robot-Assisted Thoracic Surgical Resection. Innovations�(Phila) 2014; 9:445-7. [DOI: 10.1177/155698451400900609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mediastinal parathyroid adenomas can be resected by sternotomy or video-assisted thoracoscopic surgery. Robot-assisted thoracic surgical approaches have recently been described. We report robotassisted thoracic surgical resection of a mediastinal parathyroid in a morbidly obese patient. Additional comorbidities included multiple pathological fractures related to hypercalcemia. Intraoperative parathyroid hormone levels confirmed successful removal of the adenoma. Hungry bone syndrome developed after surgery but eventually resolved. Robotassisted thoracic surgery avoided the need for sternotomy and associated concerns related to poor bone healing. Robot-assisted thoracic surgery has potential advantages over video-assisted thoracoscopic surgery in patients with obesity because of easier instrument articulation within the thoracic cavity rather than at the chest wall.
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Affiliation(s)
- Praveen Sridhar
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Devin W. Steenkamp
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Stephanie L. Lee
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Michael I. Ebright
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Virginia R. Litle
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
| | - Hiran C. Fernando
- Boston University School of Medicine, Boston Medical Center, Boston, MA USA
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