Symposium 22：Lung Cancer Surgery
In this symposium, we will be exploring the latest advancements in the diagnosis and treatment of surgically resected lung cancer. We will be specifically focusing on recent advancements in preoperative tumor localization, the role of radiomic study in lung cancer surgery, and recent advances in endobronchial diagnosis and treatment of lung cancer. Our three distinguished speakers will share their expertise and knowledge in these areas, providing insights into cutting-edge techniques and technologies that are changing the landscape of lung cancer surgery. We hope that this symposium will provide a platform for knowledge-sharing and collaboration among professionals in the field, ultimately leading to improved outcomes for lung cancer patients.
| Time (GMT+8) |
Topic | Speaker | Country / Region |
|---|---|---|---|
| 14:50-15:20 | Recent advances in preoperative tumor localization | Prof. Po-Kuei Hsu | Taiwan |
| 15:20-15:50 | Outcome of Sublobar resection for Ealy stage NSCLC | Dr. Tsai-Wang Huang | Taiwan |
| 15:50-16:20 | Robotic surgery in Thoracic oncology | Dr. Shuenn-Wen Kuo | Taiwan |
Recent advances in preoperative tumor localization
Abstract:
Various preoperative localization approaches, including transbronchial and transthoracic methods, as well as different markers such as dye, wires, and coils, have been widely utilized by thoracic surgeons. These methods aim to confidently remove small, non-visible, non-palpable lung tumors during thoracoscopic surgery. The so-called image-guided thoracic surgery comprises three mainstream platforms: CT scanner, bronchoscopy, and navigation systems. For example, a hybrid operating room equipped with a C-arm cone-beam CT and integrated software offers great potential as a safe and effective tool to intraoperatively localize small pulmonary nodules. An example of a bronchoscopic method for preoperative localization is the virtual-assisted lung mapping (VAL-MAP) technique developed by Japanese thoracic surgeons. However, it is a “mapping” rather than a “marking” technique. Another crucial platform is the navigation system. Although navigational bronchoscopy-guided thoracoscopic resection of small lung nodules was published a decade ago, recent advancements in thoracic navigation systems allow for both transbronchial (endobronchial) and transthoracic (percutaneous) approaches. This makes the technique applicable to the entire lung field and can be used for both preoperative localization and local ablative therapy. Our previous reports have demonstrated the feasibility and accuracy of electromagnetic navigation-guided percutaneous preoperative localization for small pulmonary nodules. Combining electromagnetic navigation-guided localization with mobile CT, this protocol features a wide field of view, quick image acquisition for in-time 3D image reconstruction, and real-time needle path navigation.
In recent years, innovative technologies, including robotic bronchoscopy, robotic navigation, and molecular imaging, have gained widespread attention in the field of minimally invasive thoracic surgery. These innovations aim to achieve more precise and efficient preoperative localization for small lung tumors. In this presentation, we will elaborate on some classic approaches and recent advances in preoperative tumor localization.
Prof. Po-Kuei Hsu
Taiwan
Outcome of Sublobar resection for Ealy stage NSCLC
Abstract:
Two randomized clinical trials, one from Japan and the other coordinated by the Alliance Group, have established new standards of surgical care for early stage non–small cell lung cancer (NSCLC). Although the trials differed in design, size, and end points, both showed that sublobar resection was noninferior to lobectomy for primary peripheral tumors measuring 2 cm or less in size. These findings changed the standard set by the Lung Cancer Study Group trial for T1 N0 M0 NSCLC. The analysis of the Alliance trial compares outcomes after segmentectomy versus wedge resection and shows no significant differences between these 2 approaches. The Japanese JCOG 0802 trial compared lobectomy with segmentectomy. What approach should a thoracic surgeon choose? Did patients of real-world practice achieve the similar excellent outcome of clinical trial?
We retrospectively reviewed the data form our institute. Of 688 enrolled patients; 354 patients underwent lobectomy; 334 patients underwent segmentectomy. The 5-year DFS was 89.8% in lobectomy group; 97% in segmentectomy group with HR of 0.315 (p =0.007). The 5-year OS was 94.6% in lobectomy group; 96.8% in segmentectomy group with HR of 0.487 (p =0.154). The Cox regression revealed the GGO ratio of 0.5 was still predictor of recurrence.
Similar oncologic outcomes after lobectomy and segmentectomy were indicated among patients with early-stage NSCLC. The real-world data was similar with results of clinical trial.
Dr. Tsai-Wang Huang
Taiwan
Current position
Professor, National Defense Medical Center (2021.08-)
Director of Management and Planning Office (2023.03.16-)
Education
1995-2002 M.D. : School of Medicine, National Defense Medical Center
2010-2017 Ph.D. : Institute of Medical Science, National Defense Medical Center
Professional Training and Employment
2004-2009 Residency train, Tri-Service General Hospital
2009-present Attending surgeon, Division of Thoracic surgery
2004-2008 Assistant Professor, National Defense Medical Center
2008-2021 Associate Professor, National Defense Medical Center
2021-present Professor of Surgery, National Defense Medical Center
2013-2023 Chief of Thoracic Division, Tri-Service General Hospital
2022.11-2023.02 Temple University Hospital, Heart & Lung Transplantation center
Robotic surgery in Thoracic oncology
Abstract:
In recent years, robotic surgery has emerged as a revolutionary advancement in the field of thoracic oncology. This presentation aims to explore the transformative impact of robotic-assisted techniques in the treatment of thoracic malignancies. Highlighting its precision, enhanced visualization, and minimally invasive nature, we will delve into the benefits that robotic surgery brings to both patients and healthcare providers. Additionally, we will address the importance of surgeon proficiency, training, and multidisciplinary collaboration in maximizing the potential of robotic surgery. As we navigate through the nuances and considerations surrounding this cutting-edge approach, we will ultimately illuminate the promising future that robotic surgery holds in revolutionizing thoracic oncology treatment strategies.
Dr. Shuenn-Wen Kuo
Taiwan
Education:
Jul. 1992 – Jun 1999: Department of Medicine, Medical college, National Taiwan University, Taipei, Taiwan (including one year of internship at the National Taiwan University Hospital)
Sep. 2005 – Jun 2010: Graduate Institute of clinical medicine, Medical college, National Taiwan University, Taipei, Taiwan
Work experience:
Jul. 1999 – Jun. 2004: Resident at Division of Thoracic surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Jul. 2004 – Sep. 2008: Surgeon, Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan
Oct. 2008 – Jan. 2010: Research fellow, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Feb. 2010 – present: Attending physician, Thoracic surgery and Surgical intensive care unit, National Taiwan University Hospital, Taipei, Taiwan
Sep. 2022-present: Assistant Professor of Thoracic surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Dr. Chien-Sheng Huang
Taiwan
- Bachelor of Medicine, China Medical University, Taichung, Taiwan, R.O.C. (1991/10 to 1998/06)
- Doctor of Philosophy, Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C. (2011/09 to 2020/06)
- Clinical Surgical Residency Training Program, Department of Surgery, Taipei Veterans General Hospital, Taiwan, R.O.C. (2000/07 to 2005/06)
- Clinical Fellowship Training Program, Department of Surgery, Taipei Veterans General Hospital, Taiwan, R.O.C. (2005/07 to 2006/06)
- Visiting Scholar, Division of Thoracic & Foregut Surgery of the Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center. (2008/11~2009/05)
- Research Scholar, Division of Heart Lung Transplantation, Division of Thoracic & Foregut Surgery of the Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center. (2009/06~2010/10)
- Visiting Scholar, Showa University International Training Center for Endoscopy (SUITE), Showa University Northern Yokohama Hospital, Yokohama, Japan (2012/07~2012/08)
Country in which Licensed to Practice Medicine:
- Physician License, Department of Health, The Executive Yuan, Taiwan, R.O.C. (No. 026965, 1998)
- Specialist License in Surgery, Department of Health, The Executive Yuan, Taiwan, R.O.C. (No. 005099, 2005)
Current Professional Titles:
- Visiting Attending, Section of Thoracic Surgery, Department of Surgery, Veterans General Hospital-Taipei, Taipei, Taiwan, R.O.C (2006/07~)
- Associate Professor, Department of Surgery, National Yang-Ming University (2022/02 ~ )
Memberships in Scientific Organizations: (Taiwan, R.O.C.)
- General Member, Taiwan Surgical Association
- General Member, Taiwan Association of Thoracic & Cardiovascular Surgery
- General Member, Taiwan Society of Pulmonary & Critical Care Medicine
- General Member, Taiwan Lung Cancer Society
Dr. Pei-Ming Huang
Taiwan
Ph.D., Clinical Medicine Institute, National Taiwan University
08/01/2018– Present Associate Professor, College of Medicine, National Taiwan University
01/2006-12/2006 Research Fellow, Massachusetts General Hospital, Harvard Medical School
07/2001 – 07/2007 Attending Surgeon, Department of Traumatology, National Taiwan University Hospital
06/1997 07/2000 Resident, Department of Surgery, National Taiwan University Hospital
Publications
1. Stripping Massage and Literature Review in Post-Thoracoscopic Chest Pain Management. Hsu J, Yu SP, Pan CT, Huang PM. Thorac Cardiovasc Surg. 2023 Aug 23.
2. Lai PS, Pan CT, Lee PC, Lai IR, Chen CN, Huang PM, Lin MT. The management of postoperative upper alimentary tract fistulas: a single-center experience of endoscopic tissue glue repair and recommendations of a systematic review. J Formos Med Assoc. 2022 Jan 5; S0929-6646(21)00586-6.
3. Hung WT, Hsu HH, Hung MH, Cheng YJ, Huang PM, Chen JS. Comparison of perioperative outcomes between intubated and nonintubated thoracoscopic surgery in children. J Formos Med Assoc. 2022 Jan;121(1 Pt 2):278-284.
4. Yu SP, Lai PS, Pan CT, Huang PM. Comparison of several alternatives for the management of severe pectus excavatum in the Nuss procedure Asian J Surg. 2021 May;44(5):738-41.
5. Huang PM. Intrapleural steroid instillation for critically ill patients with COVID-19 severe adult respiratory distress syndrome. Shock 2021 May 1;55(5):695-696.
