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Wang M, Luo X, Xiao X, Zhang L, Wang Q, Wang S, Wang X, Xue H, Zhang L, Chen Y, Lei J, Štupnik T, Scarci M, Fiorelli A, Laisaar T, Fruscio R, Elkhayat H, Novoa NM, Davoli F, Waseda R, Estill J, Norris SL, Riley DS, Tian J. CARE-radiology statement explanation and elaboration: reporting guideline for radiological case reports. BMJ Evid Based Med 2024:bmjebm-2023-112695. [PMID: 38458654 DOI: 10.1136/bmjebm-2023-112695] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
Despite the increasing number of radiological case reports, the majority lack a standardised methodology of writing and reporting. We therefore develop a reporting guideline for radiological case reports based on the CAse REport (CARE) statement. We established a multidisciplinary group of experts, comprising 40 radiologists, methodologists, journal editors and researchers, to develop a reporting guideline for radiological case reports according to the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research network. The Delphi panel was requested to evaluate the significance of a list of elements for potential inclusion in a guideline for reporting mediation analyses. By reviewing the reporting guidelines and through discussion, we initially drafted 46 potential items. Following a Delphi survey and discussion, the final CARE-radiology checklist is comprised of 38 items in 16 domains. CARE-radiology is a comprehensive reporting guideline for radiological case reports developed using a rigorous methodology. We hope that compliance with CARE-radiology will help in the future to improve the completeness and quality of case reports in radiology.
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Affiliation(s)
- Mengshu Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaojuan Xiao
- Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Shenzhen, China
| | - Linlin Zhang
- Editorial Office of Chinese Journal of Radiology, Beijing, China
| | - Qi Wang
- Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Shiyu Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Huadan Xue
- Department of Radiology, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Longjiang Zhang
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, General Hospital of Eastern Theater Command, Nanjing, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- World Health Organization Collaboration Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Junqiang Lei
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou, China
| | - Tomaž Štupnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Tanel Laisaar
- Department of Thoracic Surgery and Lung Transplantation, Lung Clinic, Tartu University Hospital, Tartu, Estonia
- Lung Clinic, Institute of Clinical Medicine, Medical Faculty, University of Tartu, Tartu, Estonia
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, IRCCS San Gerardo, Monza, Italy
| | - Hussein Elkhayat
- Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nuria M Novoa
- Thoracic Surgery, Puerta de Hierro University Hospital-Majadahonda, Madrid, Spain
- Biomedical Institute of Salamanca, Salamanca, Spain
| | - Fabio Davoli
- General & Thoracic Surgery Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Susan L Norris
- Oregon Health & Science University, Portland, Oregon, USA
| | - David S Riley
- University of New Mexico Medical School, Santa Fe, New Mexico, USA
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
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Forcada C, Gómez-Hernández MT, Fuentes MG, Rivas CE, Novoa NM, Aranda JL, Varela G, Jiménez MF. Robotic-Assisted Thoracoscopic Anatomical Lung Resection Improves Cardiopulmonary Outcomes in Patients With Body Mass Index≥25kg/m 2: A Propensity Score Matching Analysis. Arch Bronconeumol 2023; 59:779-781. [PMID: 37709586 DOI: 10.1016/j.arbres.2023.08.011] [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] [Received: 07/30/2023] [Revised: 08/01/2023] [Accepted: 08/19/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Clara Forcada
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - María Teresa Gómez-Hernández
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain.
| | - Marta G Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - Cristina E Rivas
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - José Luis Aranda
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research, Salamanca, Spain
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
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Zhang K, Ma Y, Wu J, Shi Q, Barchi LC, Scarci M, Petersen RH, Ng CSH, Hochwald S, Waseda R, Davoli F, Fruscio R, Levi Sandri GB, Gonzalez M, Wei B, Piessen G, Shen J, Zhang X, Jiao P, He Y, Novoa NM, Bedetti B, Gilbert S, Sihoe ADL, Toker A, Fiorelli A, Jimenez MF, Lerut T, Oo AY, Li GS, Tang X, Lu Y, Elkhayat H, Štupnik T, Laisaar T, Abu Akar F, Gonzalez-Rivas D, Su Z, Qiu B, Wang SD, Chen Y, Gao S. The SUPER reporting guideline suggested for reporting of surgical technique. Hepatobiliary Surg Nutr 2023; 12:534-544. [PMID: 37601001 PMCID: PMC10432285 DOI: 10.21037/hbsn-22-509] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/31/2022] [Indexed: 08/22/2023]
Abstract
Background Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical technique. The Surgical techniqUe rePorting chEcklist and standaRds (SUPER) aims to address this gap by defining reporting standards for surgical technique. The SUPER guideline intends to apply to articles that encompass surgical technique in any study design, surgical discipline, and stage of surgical innovation. Methods Following the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach, 16 surgeons, journal editors, and methodologists reviewed existing reporting guidelines relating to surgical technique, reviewed papers from 15 top journals, and brainstormed to draft initial items for the SUPER. The initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and regions. The final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER consultants. Results The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique reporting. The items are divided into six sections: background, rationale, and objectives (items 1 to 5); preoperative preparations and requirements (items 6 to 9); surgical technique details (items 10 to 15); postoperative considerations and tasks (items 16 to 19); summary and prospect (items 20 and 21); and other information (item 22). Conclusions The SUPER reporting guideline has the potential to guide detailed, comprehensive, and transparent surgical technique reporting for surgeons. It may also assist journal editors, peer reviewers, systematic reviewers, and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique. Trial Registration https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#SUPER.
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Affiliation(s)
- Kaiping Zhang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Yanfang Ma
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Jinlin Wu
- Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qianling Shi
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Leandro Cardoso Barchi
- Digestive Surgery Division, Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Rene Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Calvin S. H. Ng
- The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - Steven Hochwald
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Fabio Davoli
- Department of Thoracic Surgery, AUSL Romagna, S. Maria delle Croci Teaching Hospital, Ravenna, Italy
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Michel Gonzalez
- Service of Thoracic Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Benjamin Wei
- Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama Birmingham, Birmingham, AL, USA
| | - Guillaume Piessen
- University of Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Panpan Jiao
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yulong He
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Nuria M. Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Biomedical Institute of Salamanca, Salamanca, Spain
| | - Benedetta Bedetti
- Department of Thoracic Surgery, Helios Clinic Bonn/Rhein Sieg, Bonn, Germany
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | | | - Alper Toker
- Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marcelo F. Jimenez
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Toni Lerut
- Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium
| | - Aung Y. Oo
- Department of Cardiothoracic Surgery, Bart Heart Centre, St Bartholomew’s Hospital, London, UK
| | - Grace S. Li
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Xueqin Tang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Yawen Lu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Hussein Elkhayat
- Cardiothoracic Surgery, Assiut University, Faculty of Medicine, Assiut, Egypt
| | - Tomaž Štupnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tanel Laisaar
- Department of Thoracic Surgery and Lung Transplantation, Lunc Clinic, Tartu University Hospital, Tartu, Estonia
- Lung Clinic, Institute of Clinical Medicine, Medical Faculty, Tartu University, Tartu, Estonia
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Palestine
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Lung Transplant, Coruña University Hospital, Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhanhao Su
- Pediatric Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Qiu
- 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, China
| | | | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Shugeng Gao
- 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, China
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4
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Zhang K, Wu J, Su Z, Ma Y, Shi Q, Barchi LC, Laisaar T, Ng CSH, Gilbert S, Zhang X, Štupnik T, Lerut T, Jiao P, Elkhayat H, Novoa NM, Fruscio R, Waseda R, Petersen RH, Fiorelli A, Sihoe ADL, Gonzalez-Rivas D, Scarci M, Jimenez MF, Li GS, Tang X, Wang SD, Chen Y. The SUPER reporting guideline suggested for reporting of surgical technique: explanation and elaboration. Gland Surg 2023; 12:749-766. [PMID: 37441012 PMCID: PMC10333760 DOI: 10.21037/gs-23-76] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/29/2023] [Indexed: 07/15/2023]
Abstract
Background Surgical technique plays an essential role in achieving good health outcomes. However, the quality of surgical technique reporting remains heterogeneous. Reporting checklists could help authors to describe the surgical technique more transparently and effectively, as well as to assist reviewers and editors evaluate it more informatively, and promote readers to better understand the technique. We previously developed SUPER (surgical technique reporting checklist and standards) to assist authors in reporting their research that contains surgical technique more transparently. However, further explanation and elaboration of each item are needed for better understanding and reporting practice. Methods We searched surgical literature in PubMed, Google Scholar and journal websites published up to January 2023 to find multidiscipline examples in various article types for each SUPER item. Results We explain the 22 items of the SUPER and provide rationales item by item alongside. We provide 69 examples from 53 literature that present optimal reporting of the 22 items. Article types of examples include pure surgical technique, and case reports, observational studies and clinical trials that contain surgical technique. Examples are multidisciplinary, including general surgery, orthopaedical surgery, cardiac surgery, thoracic surgery, gastrointestinal surgery, neurological surgery, oncogenic surgery, and emergency surgery etc. Conclusions Along with SUPER article, this explanation and elaboration file can promote deeper understanding on the SUPER items. We hope that the article could further guide surgeons and researchers in reporting, and assist editors and peer reviewers in reviewing manuscripts related to surgical technique.
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Affiliation(s)
- Kaiping Zhang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Jinlin Wu
- Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhanhao Su
- Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yanfang Ma
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Qianling Shi
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Leandro Cardoso Barchi
- Department of Gastrointestinal Surgery, Faculty of Medicine São Leopoldo Mandic, São Paulo, Brazil
| | - Tanel Laisaar
- Department of Thoracic Surgery and Lung Transplantation, Lung Clinic, Tartu University Hospital, Tartu, Estonia
- Lung Clinic, Institute of Clinical Medicine, Medical Faculty, Tartu University, Tartu, Estonia
| | - Calvin S. H. Ng
- The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Tomaž Štupnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Toni Lerut
- Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium
| | - Panpan Jiao
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Hussein Elkhayat
- Cardiothoracic Surgery department, Assiut University, Faculty of Medicine, Assiut, Egypt
| | - Nuria M. Novoa
- Service of General Thoracic Surgery, Puerta de Hierro University Hospital-Majadahonda, Madrid, Spain
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Rene Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Lung Transplant, Coruña University Hospital, Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Marcelo F. Jimenez
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Grace S. Li
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Xueqin Tang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | | | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (RU), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
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Gómez-Hernández MT, Fuentes MG, Novoa NM, Rodríguez I, Varela G, Jiménez MF. Similar outcomes after newly implemented rats approach compared to standard vats for anatomical lung resection. A propensity-score matched analysis. Cir Esp 2022; 100:504-510. [PMID: 35842254 DOI: 10.1016/j.cireng.2022.06.032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 04/06/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Outcomes after the introduction of surgical innovations can be impaired by learning periods. The aim of this study is to compare the short-term outcomes of a recently implemented RATS approach to a standard VATS program for anatomical lung resections. METHODS Retrospective review of consecutive patients undergoing pulmonary anatomical resection through a minimally invasive approach since RATS approach was applied in our department (June 01, 2018, to November 30, 2019). Propensity score matching was performed according to patients' age, gender, ppoFEV1, cardiac comorbidity, type of malignancy, and type of resection. Outcome evaluation includes: overall morbidity, significant complications (cardiac arrhythmia, pneumonia, prolonged air leak, and reoperation), 30-day mortality, and length of hospital stay. Data were compared by two-sided chi-square or Fisher's exact test for categorical and Mann-Whitney U test for continuous variables. RESULTS A total of 273 patients (206 VATS, 67 RATS) were included in the study. After propensity score matching, data of 132 patients were analyzed. The thirty-days mortality was nil. Overall morbidity (RATS: 22.4%, VATS: 29.2%; p=0.369), major complications (RATS: 9% vs VATS: 9.2%; p=0.956) and the rates of specific major complications (cardiac arrhythmia RATS: 4.5%, VATS: 4.6%, p=1; pneumonia RATS:0%, VATS:4.6%, p=0.117; prolonged air leak RATS: 7.5%; VATS: 4.6%, p=0.718) and reoperation (RATS: 3%, VATS: 1.5%, p=1) were comparable between both groups. The median length of stay was 3 days in both groups (p=0.101). CONCLUSIONS A RATS program for anatomical lung resection can be implemented safely by experienced VATS surgeons without increasing morbidity rates.
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Affiliation(s)
| | - Marta G Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Israel Rodríguez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | | | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Spain
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Duan J, Tan F, Bi N, Chen C, Chen KN, Cheng Y, Chu Q, Ge D, Hu J, Huang Y, Jiang T, Long H, Lu Y, Shi M, Wang J, Wang Q, Yang F, Yang N, Yao Y, Ying J, Zhou C, Zhou Q, Zhou Q, Bongiolatti S, Brunelli A, Fiorelli A, Gobbini E, Gridelli C, John T, Kim JJ, Lin SH, Metro G, Minervini F, Novoa NM, Owen DH, Rodriguez M, Sakanoue I, Scarci M, Suda K, Tabbò F, Tam TCC, Tsuchida M, Uchino J, Voltolini L, Wang J, Gao S. Expert consensus on perioperative treatment for non-small cell lung cancer. Transl Lung Cancer Res 2022; 11:1247-1267. [PMID: 35958323 PMCID: PMC9359944 DOI: 10.21037/tlcr-22-527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Jianchun Duan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengwei Tan
- 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, China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ke-Neng Chen
- Department of Thoracic Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Ying Cheng
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Ge
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Hu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China;,Shanghai Geriatric Center, Shanghai, China
| | - Yunchao Huang
- Department of Thoracic Surgery I, Key Laboratory of Lung Cancer of Yunnan Province, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming, China
| | - Tao Jiang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi’an, China
| | - Hao Long
- State Key Laboratory of Oncology in Southern China, Department of Thoracic Surgery, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - You Lu
- Department of Thoracic Oncology, West China Hospital of Sichuan University, Chengdu, China
| | - Meiqi Shi
- Department of Medical Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jialei Wang
- Department of Thoracic Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qiming Wang
- Department of Medical Oncology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Fan Yang
- Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Nong Yang
- Department of Lung Cancer and Gastroenterology, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yu Yao
- Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jianming Ying
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caicun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qing Zhou
- Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qinghua Zhou
- Lung Cancer Institute/Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | | | | | - Alfonso Fiorelli
- Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy
| | - Elisa Gobbini
- Department of Thorax, University of Grenoble, CHU Grenoble-Alpes, La Tronche, France
| | - Cesare Gridelli
- Division of Medical Oncology, “S. G. Moscati” Hospital, Avellino, Italy
| | - Thomas John
- Department of Medical Oncology, Peter MacCallum Cancer Center 305 Grattan St, Melbourne, Australia
| | - Jae Jun Kim
- Department of Thoracic and Cardiovascular Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Steven H. Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Giulio Metro
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Fabrizio Minervini
- Department of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Nuria M. Novoa
- University Hospital of Salamanca and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Dwight H. Owen
- Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Maria Rodriguez
- Department of Thoracic Surgery, Clinica Universidad de Navarra, Madrid, Spain
| | - Ichiro Sakanoue
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Fabrizio Tabbò
- Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Terence Chi Chun Tam
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Masanori Tsuchida
- Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;,Bannan Central Hospital, Iwata, Shizuoka, Japan
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | - Jie Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- 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, China
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7
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Gómez-Hernández MT, Fuentes MG, Novoa NM, Rodríguez I, Varela G, Jiménez MF. "Obesity paradox" has not an impact on minimally invasive anatomical lung resection. Cir Esp 2022; 100:288-294. [PMID: 35598956 DOI: 10.1016/j.cireng.2022.05.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/18/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The paradoxical benefit of obesity, the 'obesity paradox', has been analyzed in lung surgical populations with contradictory results. Our goal was assessing the relationship of body mass index (BMI) to acute outcomes after minimally invasive major pulmonary resections. METHODS Retrospective review of consecutive patients who underwent pulmonary anatomical resection through a minimally invasive approach for the period 2014-2019. Patients were grouped as underweight, normal, overweight and obese type I, II and III. Adjusted odds ratios regarding postoperative complications (overall, respiratory, cardiovascular and surgical morbidity) were produced with their exact 95% confidence intervals. All tests were considered statistically significant at p<0.05. RESULTS Among 722 patients included in the study, 37.7% had a normal BMI and 61.8% were overweight or obese patients. When compared with that of normal BMI patients, adjusted pulmonary complications were significantly higher in obese type I patients (2.6% vs 10.6%, OR: 4.53 [95%CI: 1.86-12.11]) and obese type II-III (2.6% vs 10%, OR: 6.09 [95%CI: 1.38-26.89]). No significant differences were found regarding overall, cardiovascular or surgical complications among groups. CONCLUSIONS Obesity has not favourable effects on early outcomes in patients undergoing minimally invasive anatomical lung resections, since the risk of respiratory complications in patients with BMI≥30kg/m2 and BMI≥35kg/m2 is 4.5 and 6 times higher than that of patients with normal BMI.
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Affiliation(s)
| | - Marta G Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Israel Rodríguez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research (IBSAL), Spain
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research (IBSAL), Spain
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8
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Novoa NM, Fuentes MG. Digital drainage systems: reminding what is important. J Thorac Dis 2022; 14:3103-3104. [PMID: 36245603 PMCID: PMC9562539 DOI: 10.21037/jtd-22-940] [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: 07/07/2022] [Accepted: 07/28/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Nuria M. Novoa
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain
- Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
| | - Marta G. Fuentes
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain
- Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
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9
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Gómez-Hernández MT, Fuentes MG, Novoa NM, Rodríguez I, Varela G, Jiménez MF. The robotic surgery learning curve of a surgeon experienced in video-assisted thoracoscopic surgery compared with his own video-assisted thoracoscopic surgery learning curve for anatomical lung resections. Eur J Cardiothorac Surg 2021; 61:289-296. [PMID: 34535994 DOI: 10.1093/ejcts/ezab385] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 04/13/2021] [Revised: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Robotic surgery, although it shares some technical features with video-assisted thoracoscopic surgery (VATS), offers some advantages, such as ergonomic design and a 3-dimensional view. Thus, the learning curve for robotic lung resection could be expected to be shorter than that of VATS for surgeons who are proficient in VATS. The goal of this study was to analyse the robotic learning curve of a VATS experienced surgeon and to compare it to his own VATS learning curve for anatomical lung resections. METHODS We conducted a retrospective observational study based on the prospectively recorded data of the first 150 anatomical lung resections performed with VATS (75 cases) and with the robotic (75 cases) approach by the same surgeon in our centre. Learning curves were analysed using the cumulative sum method to assess the trends for total operating time and surgical failure (intraoperative complications, conversion, technical postoperative complications and reintervention) across case sequences. Subsequently, using adequate statistical tests, we compared the postoperative outcomes in both groups. RESULTS The median operating time was similar for both approaches (P = 0.401). Surgical failure rate was higher for the robotic cases (21.3% vs 12%; P = 0.125). Based on cumulative sum analyses, operating time decreased starting with case 34 in the VATS group and with case 32 in the robotic cohort. Surgical failure tended to decline starting with case 28 in the VATS group and with case 32 in the robotic group. Perioperative results were similar in both groups. CONCLUSIONS When we compared robotic and VATS learning curves for anatomical lung resection, we did not find any differences. Postoperative outcomes were also similar with both approaches.
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Affiliation(s)
- María Teresa Gómez-Hernández
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research, Salamanca, Spain.,University of Salamanca, Salamanca, Spain
| | - Marta G Fuentes
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research, Salamanca, Spain.,University of Salamanca, Salamanca, Spain
| | - Nuria M Novoa
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research, Salamanca, Spain.,University of Salamanca, Salamanca, Spain
| | - Israel Rodríguez
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research, Salamanca, Spain
| | - Marcelo F Jiménez
- Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research, Salamanca, Spain.,University of Salamanca, Salamanca, Spain
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10
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Zhang K, Ma Y, Shi Q, Shen J, Wu J, Zhang X, Jiao P, Li GS, Tang X, Petersen RH, Ng CSH, Fiorelli A, Novoa NM, Bedetti B, Levi Sandri GB, Hochwald S, Lerut T, Sihoe ADL, Barchi LC, Gilbert S, Waseda R, Toker A, Gonzalez-Rivas D, Fruscio R, Scarci M, Davoli F, Piessen G, Qiu B, Wang SD, Chen Y, Gao S. Evidence on reporting guidelines for surgical technique in clinical disciplines: a scoping review protocol. Gland Surg 2021; 10:2325-2333. [PMID: 34422603 DOI: 10.21037/gs-21-311] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/23/2021] [Indexed: 11/06/2022]
Abstract
Background The reporting of surgical techniques is of mixed quality, with most at a very minimal level. Reporting guidelines that could be applied to guide surgical technique reporting vary in methodology for development, discipline coverage, dimension coverage and detail requested. However, a scoping review that could indicate the gaps and efforts needed in surgical technique reporting guidelines is lacking and warranted. This study aims to design a methodological rigour protocol to guide the development of a scoping review of surgical technique reporting guidelines. Methods This protocol is designed following the 2020 manual proposed by the Joanna Briggs Institute. To further ensure the soundness of the protocol, we also included multidisciplinary professionals (including methodologists, clinicians, and journal editors) to refine the protocol. Discussion Seven key steps for developing the scoping review are identified and presented in detail, including (I) identifying the research questions; (II) inclusion criteria; (III) search strategy; (IV) source of evidence selection; (V) data extraction; (VI) analysis of the evidence; and (VII) presentation of the results. Guided by this protocol, the subsequent scoping review will inform us the overview of surgical technique reporting guidelines and precisely guide our direction and next steps in improving surgical technique reporting guidelines. Trial registration This protocol is not registered as the PROSPERO database only accepts registration of systematic review protocols while does not accept registration of scoping review protocols.
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Affiliation(s)
- Kaiping Zhang
- Editorial Office, AME Publishing Company, Hong Kong, China.,School of Public Health, Imperial College London, London, UK
| | - Yanfang Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Jinlin Wu
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Panpan Jiao
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Grace S Li
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Xueqin Tang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - René Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Calvin S H Ng
- The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca, Spain
| | - Benedetta Bedetti
- Department of Thoracic Surgery, Helios Clinic Bonn/Rhein Sieg, Bonn, Germany
| | | | - Steven Hochwald
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Toni Lerut
- Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium
| | | | - Leandro Cardoso Barchi
- Digestive Surgery Division, Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Alper Toker
- Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Lung Transplant, Coruña University Hospital, Coruña, Spain.,Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain.,Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.,Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Marco Scarci
- Department of Thoracic Surgery, S. Gerardo Hospital, Monza, Italy
| | - Fabio Davoli
- Department of Thoracic Surgery, AUSL Romagna, S. Maria delle Croci Teaching Hospital, Ravenna, Italy
| | - Guillaume Piessen
- University of Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - Bin Qiu
- 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, China
| | - Stephen D Wang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Yaolong Chen
- World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.,Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Shugeng Gao
- 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, China
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11
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Zhang K, Ma Y, Shi Q, Wu J, Shen J, He Y, Zhang X, Jiao P, Li GS, Tang X, Petersen RH, Ng CSH, Fiorelli A, Novoa NM, Bedetti B, Levi Sandri GB, Hochwald S, Lerut T, Sihoe ADL, Barchi LC, Gilbert S, Waseda R, Toker A, Gonzalez-Rivas D, Fruscio R, Scarci M, Davoli F, Piessen G, Qiu B, Wang SD, Chen Y, Gao S. Developing the surgical technique reporting checklist and standards: a study protocol. Gland Surg 2021; 10:2591-2599. [PMID: 34527570 PMCID: PMC8411094 DOI: 10.21037/gs-21-312] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/14/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Standardized and transparent reporting of surgical technique is the cornerstone of effective dissemination, implementation and improvement. However, current reporting of surgical techniques is inadequate. The existing guidelines potentially applied to guide surgical technique reporting are with a minimal highlight of the surgical technique, lack requirements explaining what extent and dimensions need to be described in detail, or are unlikely to extrapolate to a wide range of surgical techniques. This study aims to formulate a rigorous protocol to develop a surgical technique reporting checklist and standards (SUPER) that defines what a clear, comprehensive and detailed surgical technique report should be contained. METHODS This protocol is designed following the classic guidance for developing reporting guidelines recommended by the EQUATOR network. RESULTS The development team will consist of surgeons (~80%), methodologists, and journal editors. The draft checklist sources will include a scoping review of existing reporting guidelines related to surgical technique, surgical technique articles from 15 top journals published in the last year, and brainstorming by the multidisciplinary development team. The final SUPER checklist will be formed after three rounds of Delphi surveys, one round of face-to-face meeting, and a month-long pilot test. The SUPER checklist will be published as open-access and be used in combination with existing reporting guidelines related to surgical techniques (e.g., IDEAL). This protocol will steer the SUPER checklist's development, allowing us to further elaborate surgical technique reporting for all surgical specialties, and enabling a more favorable experience for surgeons, nurses, medical students, residents, editors, and reviewers. TRIAL REGISTRATION This trial is registered at the EQUATOR network on December 18th, 2020. Available at: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/.
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Affiliation(s)
- Kaiping Zhang
- Editorial Office, AME Publishing Company, Hong Kong, China
- School of Public Health, Imperial College London, London, UK
| | - Yanfang Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Jinlin Wu
- Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China
| | - Yulong He
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Xianzhuo Zhang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Panpan Jiao
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Grace S. Li
- Editorial Office, AME Publishing Company, Hong Kong, China
| | - Xueqin Tang
- Editorial Office, AME Publishing Company, Hong Kong, China
| | | | - Calvin S. H. Ng
- The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Nuria M. Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Biomedical Institute of Salamanca, Salamanca, Spain
| | - Benedetta Bedetti
- Department of Thoracic Surgery, Helios Clinic Bonn/Rhein Sieg, Bonn, Germany
| | | | - Steven Hochwald
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Toni Lerut
- Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium
| | | | - Leandro Cardoso Barchi
- Digestive Surgery Division, Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Alper Toker
- Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, Morgantown, WV, USA
| | - Diego Gonzalez-Rivas
- Department of Thoracic Surgery and Lung Transplant, Coruña University Hospital, Minimally Invasive Thoracic Surgery Unit (UCTMI), Coruña, Spain
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Marco Scarci
- Department of Thoracic Surgery, S. Gerardo Hospital, Monza, Italy
| | - Fabio Davoli
- Department of Thoracic Surgery, AUSL Romagna, S. Maria delle Croci Teaching Hospital, Ravenna, Italy
| | - Guillaume Piessen
- University of Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - Bin Qiu
- 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, China
| | | | - Yaolong Chen
- World Health Organization (WHO) Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
- Lanzhou University Institute of Health Data Science, Lanzhou, China
| | - Shugeng Gao
- 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, China
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12
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Gómez-Hernández MT, Martínez EJ, Fuentes MG, Paz M, Rodríguez I, Novoa NM, Jiménez MF. Extracorporeal membrane oxygenation (ECMO) as bridge therapy to surgery in a patient with acute respiratory distress syndrome (ARDS) due to rupture of a pulmonary hydatid cyst. Arch Bronconeumol 2021; 57:503-504. [PMID: 35698964 DOI: 10.1016/j.arbr.2021.05.005] [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] [Received: 08/20/2020] [Accepted: 11/01/2020] [Indexed: 06/15/2023]
Affiliation(s)
| | - Ernest J Martínez
- Unidad de Cuidados Intensivos, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Marta G Fuentes
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Marta Paz
- Unidad de Cuidados Intensivos, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Israel Rodríguez
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Nuria M Novoa
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Marcelo F Jiménez
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
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13
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Gómez-Hernández MT, Fuentes MG, Novoa NM, Rodríguez I, Varela G, Jiménez MF. Similar outcomes after newly implemented rats approach compared to standard vats for anatomical lung resection. A propensity-score matched analysis. Cir Esp 2021; 100:S0009-739X(21)00135-4. [PMID: 33985760 DOI: 10.1016/j.ciresp.2021.04.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 02/12/2021] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Outcomes after the introduction of surgical innovations can be impaired by learning periods. The aim of this study is to compare the short-term outcomes of a recently implemented RATS approach to a standard VATS program for anatomical lung resections. METHODS Retrospective review of consecutive patients undergoing pulmonary anatomical resection through a minimally invasive approach since RATS approach was applied in our department (June 01, 2018, to November 30, 2019). Propensity score matching was performed according to patients' age, gender, ppoFEV1, cardiac comorbidity, type of malignancy, and type of resection. Outcome evaluation includes: overall morbidity, significant complications (cardiac arrhythmia, pneumonia, prolonged air leak, and reoperation), 30-day mortality, and length of hospital stay. Data were compared by two-sided chi-square or Fisher's exact test for categorical and Mann-Whitney U test for continuous variables. RESULTS A total of 273 patients (206 VATS, 67 RATS) were included in the study. After propensity score matching, data of 132 patients were analyzed. The thirty-days mortality was nil. Overall morbidity (RATS: 22.4%, VATS: 29.2%; p=0.369), major complications (RATS: 9% vs VATS: 9.2%; p=0.956) and the rates of specific major complications (cardiac arrhythmia RATS: 4.5%, VATS: 4.6%, p=1; pneumonia RATS:0%, VATS:4.6%, p=0.117; prolonged air leak RATS: 7.5%; VATS: 4.6%, p=0.718) and reoperation (RATS: 3%, VATS: 1.5%, p=1) were comparable between both groups. The median length of stay was 3 days in both groups (p=0.101). CONCLUSIONS A RATS program for anatomical lung resection can be implemented safely by experienced VATS surgeons without increasing morbidity rates.
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Affiliation(s)
| | - Marta G Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Israel Rodríguez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | | | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research, Spain
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14
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Abstract
The surgical setting is a highly complex environment where, in ideal conditions, everything should be under control to ensure a positive outcome. However, the existing complexity opens the possibility for multiple failures along the process and many of those failures are related to what is call the non-technical skills of the members of the team. We cannot eradicate human error, but we can try to avoid future mistakes in our daily practice introducing the awareness for providing a high-quality care in which patient safety is crucial. This paper presents an easy approach to concepts and teaching possibilities of those non-technical skills.
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Affiliation(s)
- Gianluca Casali
- Thoracic Surgery, University Hospital Bristol NHS Foundation Trust, Bristol, UK
| | - Gareth Lock
- Human in the System Consulting Limited, Malmesbury, UK
| | - Nuria M. Novoa
- Service of Thoracic Surgery, University Hospital of Salamanca, Salamanca, Spain
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15
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Gómez-Hernández MT, Fuentes MG, Novoa NM, Rodríguez I, Varela G, Jiménez MF. "Obesity paradox" has not an impact on minimally invasive anatomical lung resection. Cir Esp 2021; 100:S0009-739X(21)00040-3. [PMID: 33637296 DOI: 10.1016/j.ciresp.2021.01.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The paradoxical benefit of obesity, the 'obesity paradox', has been analyzed in lung surgical populations with contradictory results. Our goal was assessing the relationship of body mass index (BMI) to acute outcomes after minimally invasive major pulmonary resections. METHODS Retrospective review of consecutive patients who underwent pulmonary anatomical resection through a minimally invasive approach for the period 2014-2019. Patients were grouped as underweight, normal, overweight and obese type I, II and III. Adjusted odds ratios regarding postoperative complications (overall, respiratory, cardiovascular and surgical morbidity) were produced with their exact 95% confidence intervals. All tests were considered statistically significant at p<0.05. RESULTS Among 722 patients included in the study, 37.7% had a normal BMI and 61.8% were overweight or obese patients. When compared with that of normal BMI patients, adjusted pulmonary complications were significantly higher in obese type I patients (2.6% vs 10.6%, OR: 4.53 [95%CI: 1.86-12.11]) and obese type II-III (2.6% vs 10%, OR: 6.09 [95%CI: 1.38-26.89]). No significant differences were found regarding overall, cardiovascular or surgical complications among groups. CONCLUSIONS Obesity has not favourable effects on early outcomes in patients undergoing minimally invasive anatomical lung resections, since the risk of respiratory complications in patients with BMI≥30kg/m2 and BMI≥35kg/m2 is 4.5 and 6 times higher than that of patients with normal BMI.
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Affiliation(s)
| | - Marta G Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Israel Rodríguez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research (IBSAL), Spain
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain; Salamanca Institute of Biomedical Research (IBSAL), Spain
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16
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Abstract
During the last decades, women have been discouraged from entering the medical career and in particular in the surgical specialties. This situation is changing across continents and national and international initiatives are supporting aspiring female surgeons in pursuing the surgical career through mentorship and fellowship programmes. Due to the differences in training programmes, Health Care systems and cultural backgrounds, it’s not easy to describe unanimously the pathways and obstacles that junior female thoracic surgeons are experiencing in Europe. The development of female surgical associations, mentorship programmes and national initiatives will further champion the gender equality in this specialty across Europe. During the recent years, the European Society of Thoracic Surgeons (ESTS) has established initiatives like the first ESTS Women in Thoracic Surgery Scientific Session or the annual Women in Thoracic ESTS Reception during the Annual Conference, which are done in an effort to encourage all female colleagues to join this specialty and increase the opportunity to share their experience and meet potential mentors. In this article we will depict the situation in some of the European countries whose female thoracic surgeons have led their way. We aim to give the next generation the examples that can influence women’s choice of surgical career, and the possible strategies and initiatives to reduce the gender discrimination within healthcare.
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Affiliation(s)
- Cecilia Pompili
- Department of Thoracic Surgery, University of Leeds, Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, Leeds, UK
| | - Giulia Veronesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy.,Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nuria M Novoa
- Thoracic Surgery Service, School of Medicine, Salamanca University, Salamanca, Spain
| | | | - Annabel J Sharkey
- Department of Cardio-Thoracic Surgery, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - Farah Bhatti
- Department of Cardio-Thoracic Surgery, Morriston Hospital, Swansea, UK.,Royal College of Surgeons of England, London, UK
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
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17
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Gómez-Hernández MT, Novoa NM, Antúnez P, Jiménez MF. Twice Lucky: Elderly Patient Surviving Both COVID-19 and Serendipitous Lung Carcinoma. Arch Bronconeumol 2020; 56:826-828. [PMID: 33994640 PMCID: PMC7834073 DOI: 10.1016/j.arbr.2020.07.012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Patricia Antúnez
- Service of Anatomical Pathology, Salamanca University Hospital, Salamanca, Spain
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
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18
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Gómez-Hernández MT, Novoa NM, Antúnez P, Jiménez MF. Twice Lucky: Elderly Patient Surviving Both COVID-19 and Serendipitous Lung Carcinoma. Arch Bronconeumol 2020; 56:826-828. [PMID: 32800389 PMCID: PMC7381892 DOI: 10.1016/j.arbres.2020.07.009] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Affiliation(s)
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Patricia Antúnez
- Service of Anatomical Pathology, Salamanca University Hospital, Salamanca, Spain
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
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19
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Gómez-Hernández MT, Martínez EJ, Fuentes MG, Paz M, Rodríguez I, Novoa NM, Jiménez MF. Pulmonar Extracorporeal Oxygenation Membrane (ECMO) as Bridge Therapy to Surgery in a Patient with Acute Respiratory Dystres Syndrome (ARDS) due to the Rupture of a Pulmonary Hydathid Cyst. Arch Bronconeumol 2020:S0300-2896(20)30518-4. [PMID: 33358225 DOI: 10.1016/j.arbres.2020.11.001] [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] [Received: 08/20/2020] [Revised: 10/14/2020] [Accepted: 11/01/2020] [Indexed: 11/15/2022]
Affiliation(s)
| | - Ernest J Martínez
- Unidad de Cuidados Intensivos. Hospital Universitario de Salamanca, Salamanca, España
| | - Marta G Fuentes
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | - Marta Paz
- Unidad de Cuidados Intensivos. Hospital Universitario de Salamanca, Salamanca, España
| | - Israel Rodríguez
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | - Nuria M Novoa
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | - Marcelo F Jiménez
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
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20
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Novoa NM, Esteban P, Gómez Hernández MT, Fuentes MG, Varela G, Jiménez MF. Early exercise pulmonary diffusing capacity of carbon monoxide after anatomical lung resection: a word of caution for fast-track programmes. Eur J Cardiothorac Surg 2020; 56:143-149. [PMID: 30726898 DOI: 10.1093/ejcts/ezz007] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/10/2018] [Accepted: 12/16/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES In healthy individuals, increasing pulmonary blood flow during exercise also increases the % of the diffusing capacity of the lungs for carbon monoxide (DLCO%), but its evolution after lung resection is unknown. In this study, our goal was to measure changes in exercise DLCO% during the first 3 days after anatomical lung resection. METHODS We performed a prospective observational study on consecutive patients with non-small-cell lung cancer scheduled for anatomical resection, except pneumonectomy, during a 6-month period. Patients underwent measurement of the DLCO% by a single-breath technique adjusted by the concentration of haemoglobin-before and after standardized exercise the day before and 3 consecutive days after surgery. The delta (Δ) variation (basal versus exercise) was calculated. The number of functioning resected segments was calculated by bronchoscopy. Postoperative pain and pleural air leak were estimated using a visual analogue scale and graduated conventional pleural drainage systems, respectively, and their influence on ΔDLCO each postoperative day was evaluated by linear regression analysis. RESULTS Fifty-seven patients were included. The visual analogue scale of pain and pleural air leaks were not correlated to Δ values (model R2: 0.0048). The evolution of Δ values during 3 postoperative days showed a progressive recovery of values, but on the third day, DLCO% capacity during exercise was still impaired (P < 0.01), especially in patients who underwent a resection of more than 3 functioning segments. CONCLUSIONS Physiological increase in DLCO% during exercise is still impaired on the third postoperative day in patients undergoing resection of more than 3 functioning pulmonary segments. This fact should be considered before discharging those patients after anatomical lung resection.
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Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Pedro Esteban
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Maria Teresa Gómez Hernández
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Marta G Fuentes
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- Institute of Biomedical Research of Salamanca. Salamanca, Spain
| | - Marcelo F Jiménez
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
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21
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Varela G, Novoa NM. EGFR and non-small cell lung cancer: implications for surgical practice. Ann Transl Med 2020; 8:1115. [PMID: 33145334 PMCID: PMC7575960 DOI: 10.21037/atm.2020.04.47] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Gonzalo Varela
- Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Nuria M. Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
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22
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Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
| | - Marta G Fuentes
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
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23
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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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24
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Abstract
Monitoring the quality of new or ongoing surgical activities is a necessity. Several Statistical Process Control (SPC) tools are available to professionals. Among them, Shewhart charts and cumulative sum charts (CUSUM charts) are useful methods to provide visual feedback before significant quality issues arise. In this paper, we discuss both methods based on our current approach. On Shewhart charts, one variable value is plotted on a time-series line. This method provides information about every single determination. Random variations of the values appear and by adjusting the adequate control limits it is possible to know whether those variations are random or out-of-control. Although large variations are easily detected, small but relevant changes are not. On the contrary, CUSUM charts have the capability of detecting small changes quickly. CUSUM is defined as a statistical tool that graphically represents the sequential monitoring of cumulative performance of any dichotomized or continuous variable under assessment. It emphasizes failures penalizing them against the correct performance when individual risk is adjusted. This makes CUSUM especially sensitive to negative changes. CUSUM can be created without the need of a specific sample size and grow with every new case included. Besides the variable under control (with specific definitions of acceptable and unacceptable outcomes), the type I and II errors for the defined parameter and the individual risk of acceptable or unacceptable outcomes must be included in the chart. Graphical representation of these three parameters is easy and intuitive to read making CUSUM graphs a reliable tool to understand the trending of the parameter under control. If performance is considered inadequate: analysis, discussion and implementation of agreed measures should be taken. Despite its limitations, CUSUM analysis is considered the best tool for quality control in health care domain.
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Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca, Spain
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25
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Varela G, Novoa NM. Definitive radiation for early stage lung cancer: who is medically inoperable? Ann Transl Med 2020; 7:S361. [PMID: 32016079 DOI: 10.21037/atm.2019.09.49] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Gonzalo Varela
- Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Nuria M Novoa
- Thoracic Surgery Service, Salamanca University Hospital and School of Medicine, Salamanca, Spain
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26
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Gómez-Hernández MT, Novoa NM, Varela G, Jiménez MF. Quality Control in Anatomical Lung Resection. Major Postoperative Complications vs Failure to Rescue. Arch Bronconeumol 2020; 57:251-255. [PMID: 31982251 DOI: 10.1016/j.arbres.2019.12.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Failure to rescue (FTR) is defined by the number of deaths among patients experiencing major complications after surgery. In this report we analyze FTR and apply a cumulative sum control chart (CUSUM) methodology for monitoring performance in a large series of operated lung carcinoma patients. METHODS Prospectively stored records of cases undergoing anatomical lung resection in one center were reviewed. Postoperative adverse events were coded and included as a binary variable (major, or minor complications). The occurrence of 30-day mortality was also recorded. Patients dying after suffering major complications were considered as FTR. Risk-adjusted CUSUM graphs using EuroLung1 and 2 variables were constructed for major complications and FTR. Points of plateauing or trend inversion were checked to detect intentional or non-adverted changes in the process of care. RESULTS 2237 cases included. 9.1% cases suffered major complications. The number of cases considered as failures to rescuing was 46 (2.1% of the total series and 22.5% of cases having major complications). The predictive performance of EuroLung1 and 2 models was as follows: EuroLung1 (major morbidity) C-index 0.70 (95%CI: 0.66-0.73); EuroLung2 (applied to FTR) C-index 0.81 (95%CI: 0.750.87). CUSUM graphs depicted improvement in rescuing complicated patients after case 330 but no improvement in the rate of non-complicated cases until case 720. CONCLUSIONS FTR offers a complementary view to classical outcomes for quality assessment in Thoracic Surgery. Our study also shows how the analysis of FTR on time series can be applied to evaluate changes in team performance along time.
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Affiliation(s)
| | - Nuria M Novoa
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research (IBSAL), Spain.
| | - Marcelo F Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
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27
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Jin K, Hu Q, Xu J, Wu C, Hsin MK, Zirafa CC, Novoa NM, Bongiolatti S, Cerfolio RJ, Shen J, Ma D. The 100 most cited articles on thoracic surgery management of lung cancer. J Thorac Dis 2019; 11:4886-4903. [PMID: 31903279 DOI: 10.21037/jtd.2019.11.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Ke Jin
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Quanteng Hu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Jianfeng Xu
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, China
| | - Chunlei Wu
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Michael K Hsin
- Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong, China.,Department of Medicine, Hong Kong University, Hong Kong, China
| | - Carmelina C Zirafa
- Minimally Invasive and Robotic Thoracic Surgery, Robotic Multispecialty Center of Surgery, University Hospital of Pisa, Pisa, Italy
| | - Nuria M Novoa
- General Thoracic Surgery Service, University Hospital of Salamanca and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Stefano Bongiolatti
- Thoracic Surgery Unit, University Hospital Careggi, Largo Brambilla, 1, 50134, Florence, Italy
| | - Robert J Cerfolio
- Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY, USA
| | - Jianfei Shen
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
| | - Dehua Ma
- Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, China
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28
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Varela G, Novoa NM. Re: Oncological results of full thoracoscopic major pulmonary resections for clinical Stage I non-small-cell lung cancer. Eur J Cardiothorac Surg 2019; 55:271-272. [PMID: 30060162 DOI: 10.1093/ejcts/ezy268] [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)
- Gonzalo Varela
- Department of Surgery, School of Medicine, Salamanca University, Salamanca, Spain
| | - Nuria M Novoa
- Department of Surgery, Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain
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29
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Li S, Han Z, He J, Gao S, Liu D, Liu L, He J, Huang Y, Xu S, Mao W, Tan Q, Chen C, Li X, Zhang Z, Jiang G, Xu L, Zhang L, Fu J, Li H, Wang Q, Tan L, Li D, Zhou Q, Fu X, Jiang Z, Chen H, Fang W, Zhang X, Li Y, Tong T, Yu Z, Liu Y, Zhi X, Yan T, Zhang X, Imperatori A, Ibrahim M, Novoa NM, Ng CSH, Petersen RH, Chen JS, Fukuchi Y, Brunelli A, Ismail M, Valverde JA, Rodriguez-Lucas C. Society for Translational Medicine expert consensus on the use of antibacterial drugs in thoracic surgery. J Thorac Dis 2019; 10:6356-6374. [PMID: 30622808 DOI: 10.21037/jtd.2018.10.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhijun Han
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jie He
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Shugeng Gao
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Deruo Liu
- Department of Thoracic Surgery, China and Japan Friendship Hospital, Beijing 100096, China
| | - Lunxu Liu
- Department of Cardiovascular and Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China
| | - Yunchao Huang
- Department of Thoracic and Cardiovascular Surgery, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming 650118, China
| | - Shidong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin 150086, China
| | - Weimin Mao
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Qunyou Tan
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Zhu Zhang
- Department of Thoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital of Tongji University, Shanghai 200433, China
| | - Lin Xu
- Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Nanjing 210009, China
| | - Lanjun Zhang
- Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Jianhua Fu
- Department of Thoracic Surgery, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Beijing 100020, China
| | - Qun Wang
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Lijie Tan
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Danqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Qinghua Zhou
- Department of Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhongmin Jiang
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xun Zhang
- Tianjin Chest Hospital, Tianjin 300051, China
| | - Yin Li
- Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Ti Tong
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun 130041, China
| | - Zhentao Yu
- Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yongyu Liu
- Department of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shenyang 110042, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Tiansheng Yan
- Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100083, China
| | - Xingyi Zhang
- Department of Thoracic Surgery, The Second Hospital of Jilin University, Changchun 130041, China
| | - Andrea Imperatori
- Center for Thoracic Surgery, Department of Medicine and Surgery, School of Medicine, University of Insubria, Varese, Italy
| | - Mohsen Ibrahim
- Division of Thoracic Surgery, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome 'Sapienza', Rome, Italy
| | - Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Calvin Sze Hang Ng
- Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China
| | - René Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, 10002, Taipei
| | | | | | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany.,Academic Hospital of the Charité-Universitätsmedizin, Humboldt University Berlin, Berlin, Germany
| | - Javier Aragón Valverde
- Departament of Thoracic Surgery, Asturias University Central Hospital, Oviedo, Asturias, Spain
| | - Carlos Rodriguez-Lucas
- Department of Microbiology, Asturias University Central Hospital, Oviedo, Asturias, Spain
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30
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Mao Y, Yu Z, You B, Fang W, Badgwell B, Berry MF, Ceppa DP, Chen C, Chen H, Cuesta MA, D'Journo XB, Eslick GD, Fu J, Fu X, Gao S, He J, He J, Huang Y, Jiang G, Jiang Z, Kim JY, Li D, Li H, Li S, Liu D, Liu L, Liu Y, Li X, Li Y, Mao W, Molena D, Morse CR, Novoa NM, Tan L, Tan Q, Toker A, Tong T, Wang Q, Weksler B, Xu L, Xu S, Yan T, Zhang L, Zhang X, Zhang X, Zhang Z, Zhi X, Zhou Q. Society for Translational Medicine Expert consensus on the selection of surgical approaches in the management of thoracic esophageal carcinoma. J Thorac Dis 2019; 11:319-328. [PMID: 30863610 DOI: 10.21037/jtd.2018.12.07] [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: 02/05/2023]
Affiliation(s)
- Yousheng Mao
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Zhentao Yu
- Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Bin You
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Jiao Tong University, Shanghai 200030, China
| | - Brian Badgwell
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark F Berry
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA
| | - DuyKhanh P Ceppa
- Division of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Jiao Tong University, Shanghai 200030, China.,Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Miguel A Cuesta
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Guy D Eslick
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Kingswood, Australia
| | - Jianhua Fu
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shugeng Gao
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China
| | - Jie He
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Yunchao Huang
- Department of Thoracic and Cardiovascular Surgery, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming 650118, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital of Tongji University, Shanghai 200433, China
| | - Zhongmin Jiang
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China
| | - Jae Y Kim
- Department of Surgery, Division of Thoracic Surgery, City of Hope Cancer Center, Duarte, CA, USA
| | - Danqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing 100730, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Shanqing Li
- Department of Thoracic Surgery, China and Japan Friendship Hospital, Beijing 100029, China
| | - Deruo Liu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medicine, Beijing 100730, China
| | - Lunxu Liu
- Department of Cardiovascular and Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yongyu Liu
- Department of Thoracic Surgery, Liaoning Cancer Hospital and Institute Shenyang 110042, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Yin Li
- Department of Thoracic Surgery, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Weimin Mao
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Daniela Molena
- Director of Esophageal Surgery, Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, Los Angeles, CA, USA
| | - Christopher R Morse
- Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca, Spain
| | - Lijie Tan
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Qunyou Tan
- Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China
| | - Alper Toker
- Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Ti Tong
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun 130041, China
| | - Qun Wang
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Benny Weksler
- Division of Thoracic Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Lin Xu
- Department of Thoracic Surgery, Nanjing Medical University Affiliated Cancer Hospital, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Cancer Institute of Jiangsu Province, Nanjing 210009, China
| | - Shidong Xu
- Department of Thoracic surgery, Harbin Medical University Cancer Hospital, Harbin 150086, China
| | - Tiansheng Yan
- Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100191, China
| | - Lanjun Zhang
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Xingyi Zhang
- Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun 130041, China
| | - Xun Zhang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300051, China
| | - Zhu Zhang
- Department of Thoracic Surgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Qinghua Zhou
- Department of Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
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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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Novoa NM, Esteban P, Hernandez N, Hernández MTG, Varela G. F-078RANDOMIZED TRIAL TO EVALUATE THE BENEFICIAL EFFECTS OF AN UNSUPERVISED POSTOPERATIVE PHYSICAL TRAINING PROTOCOL AFTER LUNG RESECTION: NEGATIVE RESULTS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.090] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Filosso PL, Guerrera F, Van Raemdonck D, Novoa NM, Thomas P, Louie B, Venuta F, Rendina EA, Marinus P, Lucchi M, Cattoni M, Marulli G, Rea F. F-045MANAGEMENT OF THYMIC NEUROENDOCRINE TUMOURS: A MULTICENTRE EXPERIENCE. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.045] [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: 11/12/2022] Open
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Novoa NM, Esteban P, Hernández MTG, Jimenez MF, Varela G. P-220MEASURING DIFFUSING CAPACITY ON EXERCISE IN THE IMMEDIATE PERIOD AFTER LUNG RESECTION: A FEASIBILITY ANALYSIS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.220] [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: 11/12/2022] Open
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Gao S, Zhang Z, Aragón J, Brunelli A, Cassivi S, Chai Y, Chen C, Chen C, Chen G, Chen H, Chen JS, Cooke DT, Downs JB, Falcoz PE, Fang W, Filosso PL, Fu X, Force SD, Garutti MI, Gonzalez-Rivas D, Gossot D, Hansen HJ, He J, He J, Holbek BL, Hu J, Huang Y, Ibrahim M, Imperatori A, Ismail M, Jiang G, Jiang H, Jiang Z, Kim HK, Li D, Li G, Li H, Li Q, Li X, Li Y, Li Z, Lim E, Liu CC, Liu D, Liu L, Liu Y, Lobdell KW, Ma H, Mao W, Mao Y, Mou J, Ng CSH, Novoa NM, Petersen RH, Oizumi H, Papagiannopoulos K, Pompili C, Qiao G, Refai M, Rocco G, Ruffini E, Salati M, Seguin-Givelet A, Sihoe ADL, Tan L, Tan Q, Tong T, Tsakiridis K, Venuta F, Veronesi G, Villamizar N, Wang H, Wang Q, Wang R, Wang S, Wright GM, Xie D, Xue Q, Xue T, Xu L, Xu S, Xu S, Yan T, Yu F, Yu Z, Zhang C, Zhang L, Zhang T, Zhang X, Zhao X, Zhao X, Zhi X, Zhou Q. The Society for Translational Medicine: clinical practice guidelines for the postoperative management of chest tube for patients undergoing lobectomy. J Thorac Dis 2017; 9:3255-3264. [PMID: 29221303 PMCID: PMC5708414 DOI: 10.21037/jtd.2017.08.165] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 02/05/2023]
Abstract
The Society for Translational Medicine and The Chinese Society for Thoracic and Cardiovascular Surgery conducted a systematic review of the literature in an attempt to improve our understanding in the postoperative management of chest tubes of patients undergoing pulmonary lobectomy. Recommendations were produced and classified based on an internationally accepted GRADE system. The following recommendations were extracted in the present review: (I) chest tubes can be removed safely with daily pleural fluid of up to 450 mL (non-chylous and non-sanguinous), which may reduce chest tube duration and hospital length of stay (2B); (II) in rare instances, e.g., persistent abundant fluid production, the use of PrRP/B <0.5 when evaluating fluid output to determine chest tube removal might be beneficial (2B); (III) it is recommended that one chest tube is adequate following pulmonary lobectomy, except for hemorrhage and space problems (2A); (IV) chest tube clearance by milking and stripping is not recommended after lung resection (2B); (V) chest tube suction is not necessary for patients undergoing lobectomy after first postoperative day (2A); (VI) regulated chest tube suction [-11 (-1.08 kPa) to -20 (1.96 kPa) cmH2O depending upon the type of lobectomy] is not superior to regulated seal [-2 (0.196 kPa) cmH2O] when electronic drainage systems are used after lobectomy by thoracotomy (2B); (VII) chest tube removal recommended at the end of expiration and may be slightly superior to removal at the end of inspiration (2A); (VIII) electronic drainage systems are recommended in the management of chest tube in patients undergoing lobectomy (2B).
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Affiliation(s)
- Shugeng Gao
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Zhongheng Zhang
- Department of Emergency Medicine, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | | | | | | | - Ying Chai
- Department of Thoracic Surgery, Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310009, China
| | - Chang Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fujian 350001, China
| | - Gang Chen
- Department of Thoracic Surgery, Guangdong General Hospital, Guangzhou 510080, China
| | - Haiquan Chen
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, China
| | - Jin-Shing Chen
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan
| | - David Tom Cooke
- Section of General Thoracic Surgery, University of California, Davis Health System, Sacramento, CA, USA
| | - John B. Downs
- Department of Anesthesiology and Critical Care Medicine, University of Florida, Gainesville, FL, USA
| | | | - Wentao Fang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai 200030, China
| | | | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Seth D. Force
- Cardiothoracic Surgery, Emory University, The Emory Clinic, Atlanta, GA, USA
| | - Martínez I. Garutti
- Department of Anaesthesia and Postoperative Care, Hospital General Universitario Gregorio Marañon, Madrid, Spain
| | | | - Dominique Gossot
- Department of Thoracic Surgery, Institut Mutualiste Montsouris, Paris, France
| | - Henrik Jessen Hansen
- Department of Cardiothoracic Surgery, Rigshospitalet (National University Hospital), Copenhagen, Denmark
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510000, China
| | - Jie He
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Bo Laksáfoss Holbek
- Department of Cardiothoracic Surgery and Section for Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Jian Hu
- Department of Thoracic Surgery, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003, China
| | - Yunchao Huang
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming 650100, China
| | - Mohsen Ibrahim
- Division of Thoracic Surgery, Faculty of Medicine and Psychology, Sant’Andrea Hospital, University of Rome ‘Sapienza’, Rome, Italy
| | - Andrea Imperatori
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Mahmoud Ismail
- Charité Kompetenzzentrum für Thoraxchirurgie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Hongjing Jiang
- Department of Esophageal Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Zhongmin Jiang
- Department of Thoracic Surgery, Shandong Qianfoshan Hospital, Jinan 250014, China
| | - Hyun Koo Kim
- Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Danqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing 100032, China
| | - Gaofeng Li
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming 650100, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Beijing 100049, China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Chengdu 610041, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital Fourth Military Medical University, Xi’an 710038, China
| | - Yin Li
- Henan Cancer Hospital, Zhengzhou 450008, China
| | - Zhijun Li
- Department of Thoracic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Eric Lim
- Imperial College and The Academic Division of Thoracic Surgery, Royal Brompton Hospital, Sydney Street, London, UK
| | - Chia-Chuan Liu
- Division of Thoracic Surgery, Department of Surgery, Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Deruo Liu
- Department of Thoracic Surgery, China and Japan Friendship Hospital, Beijing 100029, China
| | - Lunxu Liu
- Department of Cardiovascular and Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yongyi Liu
- Department of Thoracic Surgery, Liaoning Cancer Hospital and Institute, Shengyang 110042, China
| | - Kevin W. Lobdell
- Department of Thoracic and Cardiovascular Surgery, Sanger Heart and Vascular Institute, Carolinas Medical Center, Charlotte, NC, USA
| | - Haitao Ma
- Department of Thoracic Surgery, The First Hospital Affiliated to Soochow University, Suzhou 215000, China
| | - Weimin Mao
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310000, China
| | - Yousheng Mao
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Juwei Mou
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Calvin Sze Hang Ng
- Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China
| | - Nuria M. Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - René H. Petersen
- Department of Cardiothoracic Surgery, Rigshospitalet (National University Hospital), Copenhagen, Denmark
| | - Hiroyuki Oizumi
- Second Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | | | - Cecilia Pompili
- Department of Thoracic Surgery, St. James’s University Hospital, Leeds, UK
- Leeds Institute of Cancer and Pathology, Leeds, UK
| | - Guibin Qiao
- Department of Thoracic Surgery, Guangzhou General Hospital of Guangzhou Military Area Command, Guangzhou 510000, China
| | - Majed Refai
- Thoracic Surgery Department, United Hospitals of Ancona, Via San Vincenzo 5/f Polverigi, Ancona, Italy
| | - Gaetano Rocco
- Department of Thoracic Surgery and Oncology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | - Erico Ruffini
- Department of Thoracic Surgery, University of Torino, Torino, Italy
| | - Michele Salati
- Unit of Thoracic Surgery, Ospedali Riuniti Ancona, Ancona, Italy
| | | | - Alan Dart Loon Sihoe
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Lijie Tan
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Qunyou Tan
- Department of Thoracic Surgery, Daping Hospital, Research Institute of Surgery Third Military Medical University, Chongqing 400042, China
| | - Tang Tong
- Department of Thoracic Surgery, Second Affiliated Hospital of Jilin University, Changchun 130041, China
| | - Kosmas Tsakiridis
- Cardiac and Thoracic Department, Private Hospital “St.Lukes”, Thessaloniki, Greece
| | - Federico Venuta
- Department of Surgery “Paride Stefanini” - Thoracic Surgery Unit, Policlinico Umberto I, University of Rome SAPIENZA, Rome, Italy
| | - Giulia Veronesi
- Robotic Surgery, Division of Thoracic Surgery, Humanitas Research Hospital, Via Manzoni 56, Rozzano, Italy
| | | | - Haidong Wang
- Department of Thoracic Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Qun Wang
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Ruwen Wang
- Department of Thoracic Surgery, Daping Hospital, Research Institute of Surgery Third Military Medical University, Chongqing 400042, China
| | - Shumin Wang
- Department of Thoracic Surgery, General Hospital of Shenyang Military Area, Shenyang 110015, China
| | - Gavin M. Wright
- Department of Surgical Oncology, St Vincent’s Hospital, Melbourne, Australia
- Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Australia
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Deyao Xie
- Department of Cardiovascular and Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Qi Xue
- Department of Thoracic Surgical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; National Cancer Center, Beijing 100021, China
| | - Tao Xue
- Department of Thoracic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - Lin Xu
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing 210008, China
| | - Shidong Xu
- Department of Thoracic Surgery, Heilongjiang Cancer Hospital, Harbin 150049, China
| | - Songtao Xu
- Department of Thoracic Surgery, Shanghai Zhongshan Hospital of Fudan University, Shanghai 200032, China
| | - Tiansheng Yan
- Department of Thoracic Surgery, Peking University Third Hospital, Beijing 100083, China
| | - Fenglei Yu
- Department of Cardiovascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zhentao Yu
- Department of Esophageal Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Chunfang Zhang
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Lanjun Zhang
- Cancer Center, San Yat-sen University, Guangzhou 510060, China
| | - Tao Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xinjiang Medical Hospital, Urumqi 830011, China
| | - Xun Zhang
- Department of Thoracic Surgery, Tanjin Chest Hospital, Tianjin 300300, China
| | - Xiaojing Zhao
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200003, China
| | - Xuewei Zhao
- Department of Thoracic Surgery, Shanghai Changzheng Hospital, Shanghai 200000, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Xuanwu Hospital of Capital University of Medical Sciences, Beijing 100053, China
| | - Qinghua Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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Esteban PA, Hernández N, Novoa NM, Varela G. Evaluating patients’ walking capacity during hospitalization for lung cancer resection†. Interact Cardiovasc Thorac Surg 2017; 25:268-271. [DOI: 10.1093/icvts/ivx100] [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] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/31/2017] [Indexed: 11/14/2022] Open
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Novoa NM, Esteban P, Rodriguez M, Gomez MT, Varela G. Functional evaluation before lung resection: searching for a low technology test in a safer environment for the patient: a pilot study†. Eur J Cardiothorac Surg 2017; 51:856-860. [DOI: 10.1093/ejcts/ezw403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/01/2016] [Indexed: 11/13/2022] Open
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Gómez Hernández MT, Novoa NM, Jiménez MF. Foreign body aspiration during inhaled bronchodilator administration. Arch Bronconeumol 2017; 53:272. [PMID: 28131542 DOI: 10.1016/j.arbres.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Affiliation(s)
| | - Nuria M Novoa
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | - Marcelo F Jiménez
- Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
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Jimenez MF, Novoa NM, Varela G. Surgery Versus Stereotactic Body Radiotherapy for Resectable Lung Cancer. Curr Surg Rep 2016. [DOI: 10.1007/s40137-016-0162-1] [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: 11/27/2022]
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Abstract
The oligometastatic stage IV non-small cell lung cancer (NSCLC) offers a new surgical opportunity. New reported data is showing that surgery can offer a reasonable benefit, in terms of long-term survival, to some patients. The advantages of surgical treatment rely on a more adequate patient selection and a better understanding of the biology of these tumors. Currently, mediastinal involvement of the primary tumor can be identified as the most important prognostic variable after curative-intent of synchronous or metachronous metastasis. It seems clear that the routine use of combined FDG-PET and CT will help to detect the more favorable cohort of oligometastatic patients. As expected, pathological T staging of the primary tumor and the completeness of its resection are also crucial factors influencing final results. The real benefit of the local treatment over synchronous or metachronous metastasis is controversial with series showing better outcomes for metachronous lesions than for synchronous and others offering equal results. Also non conclusive results appear when analyzing different sites of metastasis. Retrospective series tend to show different outcomes depending on the affected organ while usually no differences are found in prospective ones. Most of the current evidence is based on retrospective studies on patients collected along extended periods of time. That represents a great limitation to the knowledge on this topic. Some prospective analyses have added some insight, but still the quality of the evidence is too low to allow drawing robust conclusions. As frequently concluded, prospective well designed investigation is requested to ascertain the value of surgery in this specific population of patients with extended NSCLC.
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Affiliation(s)
- Nuria M Novoa
- General Thoracic Service, University Hospital of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- General Thoracic Service, University Hospital of Salamanca, Salamanca, Spain
| | - Marcelo F Jiménez
- General Thoracic Service, University Hospital of Salamanca, Salamanca, Spain
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Novoa NM, Gómez MT, Rodríguez M, Jiménez López MF, Aranda JL, Bollo de Miguel E, Diez F, Hernández Hernández J, Varela G. e-Consultation Improves Efficacy in Thoracic Surgery Outpatient Clinics. Arch Bronconeumol 2016; 52:549-552. [PMID: 27208914 DOI: 10.1016/j.arbres.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/06/2016] [Revised: 03/20/2016] [Accepted: 04/03/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study is analysing the impact of the systematic versus occasional videoconferencing discussion of patients with two respiratory referral units along 6 years of time over the efficiency of the in-person outpatient clinics of a thoracic surgery service. METHOD Retrospective and comparative study of the evaluated patients through videoconferencing and in-person first visits during two equivalents periods of time: Group A (occasional discussion of cases) between 2008-2010 and Group B (weekly regular discussion) 2011-2013. Data were obtained from two prospective and electronic data bases. The number of cases discussed using e-consultation, in-person outpatient clinics evaluation and finally operated on under general anaesthesia in each period of time are presented. For efficiency criteria, the index: number of operated on cases/number of first visit outpatient clinic patients is created. Non-parametric Wilcoxon test is used for comparison. RESULTS The mean number of patients evaluated at the outpatient clinics/year on group A was 563 versus 464 on group B. The median number of cases discussed using videoconferencing/year was 42 for group A versus 136 for group B. The mean number of operated cases/first visit at the outpatient clinics was 0.7 versus 0.87 in group B (P=.04). CONCLUSIONS The systematic regular discussion of cases using videoconferencing has a positive impact on the efficacy of the outpatient clinics of a Thoracic Surgery Service measured in terms of operated cases/first outpatient clinics visit.
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Affiliation(s)
- Nuria M Novoa
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España.
| | - Maria Teresa Gómez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | - María Rodríguez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | | | - Jose L Aranda
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
| | | | - Florentino Diez
- Servicio de Neumología, Complejo Asistencial Universitario de León, León, España
| | | | - Gonzalo Varela
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
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Rodríguez M, Gómez Hernández MT, Novoa NM, Aranda JL, Jiménez MF, Varela G. Poorer Survival in Stage IB Lung Cancer Patients After Pneumonectomy. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.arbr.2015.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rodríguez M, Gómez Hernández MT, Novoa NM, Aranda JL, Jiménez MF, Varela G. Morbidity and Mortality in Octogenarians With Lung Cancer Undergoing Pneumonectomy. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.arbr.2015.03.007] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rodríguez M, Gómez Hernández MT, Novoa NM, Aranda JL, Jiménez MF, Varela G. La neumonectomía ofrece menor supervivencia a los pacientes con carcinoma de pulmón en estadio patológico IB. Arch Bronconeumol 2015; 51:223-6. [DOI: 10.1016/j.arbres.2014.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 12/01/2022]
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Abstract
Improving patient safety seems to be a new interesting clinical subject but, in fact, it is no new. It has to do with one of the oldest ethical principles of our profession: curing and not harming. The important research that has been done in a short period of time has brought in new insight to this complex area that is fast developing. The creation of safety managing systems will allow coordinating efforts from very different, although complementary, areas to create real safety culture and safety climate in every organization. In the surgical settings, teamwork is basic to provide good quality of care. Safety leaders in every team have an important role in establishing priorities, summarizing proposals, coordinating efforts, launching new initiatives and transmitting that safety efforts are worth taken. Preparedness and anticipation are key points for avoiding most of the diverse types of patient harm that can occur. As has been published, a great number of errors can be avoided simply using crosscheck based on specialized checklist that reviews every important detail of the procedure. This strategy has been demonstrated very useful at other high risk industries such as aviation, nuclear or food management. The Safe Surgery Saves Lives program launched in 2002 by the WHO has taught us that improvement is possible using a simple checklist. More complex and detail checklist can be more adequate for more complex procedures and settings. The proposed ESTS checklist reviews different areas of possible error in deeper detail allowing the finest adjustment of the patient before the skin incision. It has been recently released to the general thoracic community and monitors its use and usefulness has to be warrantied.
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Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Service, University Hospital of Salamanca, Salamanca, Spain
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Esteban González P, Novoa NM, Varela G. Transcutaneous Electrical Nerve Stimulation Reduces Post-Thoractomy Ipsilateral Shoulder Pain. A Prospective Randomized Study. Arch Bronconeumol 2015; 51:621-6. [PMID: 25555523 DOI: 10.1016/j.arbres.2014.11.002] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 10/28/2014] [Accepted: 11/03/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The patient's position during an axillary thoracotomy can cause postoperative pain and decrease mobility of the ipsilateral shoulder. In this study, we assessed whether the implementation of a standardized analgesia program using transcutaneous electrical nerve stimulation (TENS) decreases local pain and improves ipsilateral shoulder mobility. METHOD Randomized, single-blind, single-center clinical trial of 50 patients who had undergone anatomical lung resection via axillary muscle-sparing thoracotomy. Patients were treated with TENS devices for 30 minutes every 8 hours, beginning on postoperative day 1. Pain and mobility of the affected limb were recorded at the same time on postoperative days 1 through 3. A visual analogue scale was used for pain assessment and shoulder mobility was assessed with a goniometer. Results were compared using a non-parametric test. RESULTS Twenty-five patients were randomized to each group. Mean age of the control group was 62.7±9.3 years and 63.4±10.2 years in the experimental group. Shoulder mobility parameters were similar in both groups on all postoperative days. However, pain during flexion significantly decreased on day 2 (P=.03) and day 3 (P=.04) in the experimental group. CONCLUSION The use of TENS decreases pain from shoulder flexion in patients undergoing axillary thoracotomy for pulmonary resection.
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Affiliation(s)
- Pedro Esteban González
- Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España.
| | - Nuria M Novoa
- Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España
| | - Gonzalo Varela
- Servicio de Cirugía Torácica, Hospital Clínico Universitario de Salamanca, Salamanca, España
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Rodríguez M, Jiménez MF, Hernández MTG, Novoa NM, Aranda JL, Varela G. Usefulness of conventional pleural drainage systems to predict the occurrence of prolonged air leak after anatomical pulmonary resection. Eur J Cardiothorac Surg 2014; 48:612-5. [DOI: 10.1093/ejcts/ezu470] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 11/11/2014] [Indexed: 11/13/2022] Open
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Novoa NM, Rodríguez M, Gómez MT, Jiménez MF, Varela G. Fixed-altitude stair-climbing test replacing the conventional symptom-limited test. A pilot study. Arch Bronconeumol 2014; 51:268-72. [PMID: 25453531 DOI: 10.1016/j.arbres.2014.09.012] [Citation(s) in RCA: 2] [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] [Received: 07/14/2014] [Revised: 09/13/2014] [Accepted: 09/15/2014] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The objective of this study was to investigate whether a patient's maximum capacity is comparable in 2 different stair-climbing tests, allowing the simplest to be used in clinical practice. METHOD Prospective, observational study of repeated measures on 33 consecutive patients scheduled for lung resection. Stair-climbing tests were: the standard test (climb to 27 m) and the alternative fixed-altitude test (climb to 12 m). In both cases, heart rate and oxygen saturation were monitored before and after the test. The power output of stair-climbing for each test (Watt1 for the standard and Watt2 for the fixed-altitude test) was calculated using the following equation: Power (watt)=weight (kg)*9.8*height (m)/time (sec). Concordance between tests was evaluated using a regression model and the residuals were plotted against Watt1. Finally, power output values were analyzed using a Bland-Altman plot. RESULTS Twenty-one male and 12 female patients (mean age 63.2±11.2) completed both tests. Only 12 patients finished the standard test, while all finished the fixed-altitude test. Mean power output values were Watt1: 184.1±65 and Watt2: 214.5±75.1. The coefficient of determination (R(2)) in the linear regression was 0.67. No fixed bias was detected after plotting the residuals. The Bland-Altman plot showed that 32 out of 33 values were within 2 standard deviations of the differences between methods. CONCLUSIONS The results of this study show a reasonable level of concordance between both stair-climbing tests. The standard test can be replaced by the fixed-altitude test up to 12 m.
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Affiliation(s)
- Nuria M Novoa
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca, Salamanca, España.
| | - María Rodríguez
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - M Teresa Gómez
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - Marcelo F Jiménez
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - Gonzalo Varela
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
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