ABSTRACTBackgroundOptimizing perioperative management strategies to promote the rapid recovery remains a focus and challenge research. Normobaric hyperoxia enhances antioxidant defenses and promotes tissue repair, improving functional outcomes in stroke patients. This study aimed to investigate the influence of perioperative normobaric hyperoxia combined with pulmonary rehabilitation on video‐assisted thoracoscopic surgery‐treated lung cancer patients.MethodsThis trial enrolled 100 patients with pulmonary nodules scheduled for video‐assisted thoracoscopic surgery (VATS). Eligible patients were randomized in a 1:1 ratio into two groups. The primary outcomes were postoperative length of stay (LOS) and total hospitalization costs. Secondary outcomes included incidence of postoperative pulmonary complications (PPCs), postoperative inflammatory indicators, activities of daily living (ADL), perioperative outcomes, and readmission rates within 30 days and 6 months after discharge.ResultsEighty‐four patients completed the study. The intervention group experienced a significantly shorter postoperative LOS (2 days, IQR 1.8 to 3) and lower total hospitalization cost (41 185 RMB, IQR 35094 to 47 028). The intervention group reported better scores of ADL on postoperative (45 points, IQR 33.8 to 55) and discharge (95 points, IQR 90 to 100). But there were no differences in the incidence of PPCs, C‐reactive protein, procalcitonin, perioperative outcomes, and readmission rates within 30 days and 6 months after discharge.ConclusionsNormobaric hyperoxia combined with perioperative pulmonary rehabilitation may reduce postoperative LOS and decreased costs for VATS‐treated lung cancer patients. This approach expected to optimize outcomes and improve rehabilitation for early‐stage lung cancer patients.Trial Registration: The clinical trial was registered on January 17, 2018, with the registration number ChiCTR1800014512

Lung cancer remains a leading cause of global mortality despite declining rates. Since 2010, FDA-approved immune checkpoint inhibitors (ICIs) have transformed treatment. This study investigates lung cancer incidence and mortality trends, emphasizing temporal associations with ICI integration and smoking patterns. Data (1999-2020) were extracted from the CDC WONDER database. Trends were analyzed using joinpoint regression to determine the annual percent change (APC). Lung cancer incidence declined from 1999 to 2020, with the sharpest decrease post-2018 (APC -6.90) compared to 2006-2018 (APC -1.78). Males saw steeper declines than females; however, American Indians/Alaska Natives showed an increasing trend (APC 3.96). Smoking prevalence decreased overall (1965-2018), though youth smoking rose between 1992 and 2004. By 2018, smoking was highest among American Indians/Alaska Natives (25.9%). Lung cancer mortality declined steadily since 1999, accelerating after 2014 (APC -4.10). Conversely, cardiovascular (CVS) mortality decline decelerated after 2015, stabilizing between 2018 and 2020 (APC 0.82; 95% CI -0.53 to 1.81). Lung cancer incidence and mortality declined significantly over two decades. The accelerated mortality declines post-2014 coincide with the clinical integration of ICIs. The stabilization of CVS mortality after 2015 reflects a shift in the clinical profile, potentially related to competing risks and ICI-related trends, warranting further investigation into whether population-level CVS mortality is influenced by immunotherapy.

Short-form videos have become the common source of cancer information for Chinese patients and caregivers. We evaluated the content, quality, and reliability of lung cancer treatment videos on TikTok, Bilibili, and Kwai and generated evidence-based recommendations for cancer health education. We conducted a cross-sectional study of lung cancer treatment short videos on TikTok, Bilibili, and Kwai. The top 200 most-liked videos per platform posted between January 1, 2020 and October 30, 2025, were retrieved on November 1, 2025. After screening, 300 videos (100 per platform) were analyzed. Two oncologists rated quality using GQS (1-5) and DISCERN (1-5); creator identity was classified. Comment sentiment (SnowNLP) and engagement metrics were analyzed. TikTok had the highest engagement and quality (GQS 3.0, DISCERN 3.0) versus Bilibili/Kwai (2.0) (p < 0.001). Professionals achieved the highest quality (GQS 3.0) versus institutions (1.0) (p < 0.001). However, absolute quality was low across all platforms: only 6% of videos met high-quality criteria (GQS ≥ 4), and 5% met DISCERN ≥ 4. Engagement showed a weak negative correlation with quality (ρ = -0.13 to -0.21). Overall quality is low; professional content is more reliable but less viral. Embedding quality indicators in algorithms and promoting certified creators could improve patient cancer education.

Pleural mesothelioma (PM) is a rare and aggressive cancer arising from pleural mesothelial cells with a strong association to asbestos exposure. Among the diagnostic strategies available are noninvasive techniques including thoracic ultrasound (TUS), computed tomography (CT) scans, positron emission tomography (PET-CT), and invasive procedures such as thoracoscopy and pleural biopsy. Accurate identification of the histological subtype is critical for tailoring treatment strategies. The standard treatment for unresectable PM has traditionally been chemotherapy, particularly platinum and pemetrexed. However, recent advances in translational clinical research, including immune checkpoint inhibitors (ICIs), are changing the therapeutic landscape, offering new opportunities for personalized treatment. The recent FDA approval of nivolumab and ipilimumab combination therapy as a first-line treatment has significantly improved outcomes, especially for nonepithelioid subtypes. Ongoing studies are exploring additional immune-targeted therapies such as VISTA, LAG-3, and dendritic cell-based therapies. Early detection, refined biomarker identification, and a deeper understanding of the tumor microenvironment remain essential to improving PM prognosis and patient survival. This review provides a comprehensive exploration of the epidemiology, etiology, clinical manifestations, diagnostic approaches (including immunohistochemical and molecular markers), staging, and current treatment strategies for PM.

Transcervical inflatable mediastinoscopic esophagectomy (TIME), with fewer incisions and without going through the thoracic cavity, may achieve the same results and lymph node dissection compared with Thoracoscopic assisted minimally invasive esophagectomy (TAMIE). However, its small visual field increases recurrent laryngeal nerve (RLN) injury risk. Intraoperative nerve monitoring (IONM) reduces RLN paralysis in TAMIE, but few reports have used it in TIME. This paper introduces continuous IONM in TIME to protect RLN. A patient underwent TIME with continuous left RLN monitoring using an EMG endotracheal tube and APS electrode. Stimulation frequency was 1 Hz, with the alarm set at ≥ 50% EMG amplitude reduction or latency prolongation > 10%. The signals are within the normal range during the mediastinal surgery and neck anastomosis. The patient had a normal voice and symmetric vocal cord movement postoperatively. Continuous IONM in TIME may help identify and protect RLN, enabling more aggressive lymph node dissection, though it needs anesthesia cooperation to avoid muscle relaxants. It may be the best method for RLN protection in TIME in the future.

ABSTRACTImmunotherapy has transformed the therapeutic landscape of breast cancer. Nevertheless, an exhaustive overview of the treatment‐related adverse events (TRAEs) and immune‐related adverse events (irAEs) spectrum of immune checkpoint inhibitor (ICI)‐based combination therapies remains lacking. We performed a comprehensive systematic review and meta‐analysis comparing chemotherapy, antibody–drug conjugate (ADC) therapy, targeted therapy, immunotherapy, endocrine therapy, radiotherapy, and dual therapy combined with ICIs. The primary outcomes were overall incidence rates and profiles for all‐grade and grade 3 or higher TRAEs and irAEs according to random effects models. We identified 8236 records, 100 of which (9192 patients) met the inclusion criteria. For grade ≥ 3 TRAEs, the ICI‐based chemotherapy and ICI‐based ADC regimens demonstrated equivalent incidence rates, marginally exceeding those observed in the ICI‐based targeted therapy group. Analysis of irAEs revealed that ICI‐based chemotherapy combinations had a significantly lower incidence than other dual‐agent regimens did. In triplet regimens that combined ICIs with chemotherapy plus additional immunotherapy, irAEs rates remained nearly comparable to those of dual therapies. Among the therapeutic regimens analyzed, ICIs combined with multitarget tyrosine kinase inhibitors (mTKIs) presented the highest incidence rates of both all‐grade and grade ≥ 3 irAEs. Conversely, combination regimens of ICIs with poly ADP–ribose polymerase (PARP) inhibitors or HER2‐targeted monotherapy demonstrated markedly lower risks of irAEs. Our study provides comprehensive data on the TRAEs and irAEs associated with ICI‐based combination therapies. These results offer direct and practical references for clinicians to evaluate toxicity profiles and optimize treatment decisions in routine breast cancer care.

Pleomorphic carcinoma is a rare, aggressive subtype of non-small cell lung cancer (NSCLC). Invasion into the left atrium and dissemination to cerebral arteries are exceptionally uncommon, and the role of cardiopulmonary bypass (CPB)-assisted resection remains debated. We report two surgically treated cases with left atrial invasion. Case 1: A 57-year-old man underwent left lower lobectomy with partial atrial resection under CPB. One month later, he developed subarachnoid hemorrhage caused by rupture of a cerebral aneurysm secondary to metastasis; histology of the aneurysmal wall confirmed carcinoma. He remains recurrence-free at 21 months. Case 2: A 62-year-old woman underwent extended left upper lobectomy with partial atrial resection under CPB. Although adrenal metastasis was suspected radiologically, pathological confirmation was lacking preoperatively; surgery was pursued because of symptomatic disease and atrial involvement. She developed postoperative cerebral infarction and rapid adrenal progression and died at 4 months despite chemotherapy. These cases illustrate both the technical feasibility of CPB-assisted atrial resection and the aggressive biology of pleomorphic carcinoma, including atypical vascular metastasis to cerebral arteries. Careful staging, patient selection, and early multidisciplinary planning (thoracic surgery, cardiac surgery, neurosurgery, oncology, and radiology) are essential. Surgery can be justified in selected patients with atrial invasion; however, pleomorphic histology portends poor outcomes and unusual metastatic tropism. Vigilant postoperative surveillance and integration of systemic therapy are required.

ABSTRACTBackgroundThis study evaluated the safety, long‐term survival, and prognostic factors associated with salvage pulmonary surgery following systemic therapy for initially unresectable non‐small cell lung cancer (NSCLC).MethodsBetween 2014 and 2024, this single‐center retrospective review identified 32 patients (median age: 61.0 years) with NSCLC initially considered unresectable who subsequently underwent curative‐intent pulmonary resection after chemotherapy, targeted therapy, and/or immunotherapy. The primary endpoint was overall survival (OS); secondary endpoints included recurrence‐free survival (RFS), major morbidity (Clavien–Dindo grade ≥ IIIa), and R0 resection rate. The Kaplan–Meier method and log‐rank test were employed.ResultsReasons for unresectability at initial diagnosis were distant metastasis (n = 20; 62.5%), N3 nodal disease (n = 6; 18.8%), bulky N2 nodal disease (n = 3; 9.4%), and tumor or nodal extension requiring pneumonectomy (n = 3; 9.4%). Overall, 65.6% patients underwent lobectomy, with R0 resection achieved in 81.3% and pathological complete or major response observed in 15.6%. Overall complication and major morbidity rates were 12.5% and 3.1%, respectively; no 90‐day mortality was observed. After a median follow‐up of 40.1 months, median OS was not reached, whereas median RFS was 49.9 months; 5‐year OS and RFS were 75.0% (95% CI 51.6–88.3) and 46.3% (95% CI 26.3–64.2), respectively. Notably, adenocarcinoma histology was significantly more prevalent in the good‐prognosis group (88.9% vs. 35.7%, p = 0.003).ConclusionsSalvage pulmonary surgery following systemic therapy is safe, yielding a 5‐year OS rate of 75% in carefully selected patients with advanced NSCLC. Prevalent adenocarcinoma histology in the good‐prognosis cohort is associated with superior outcomes.

ABSTRACTObjectiveTo evaluate the effect of postoperative adjuvant immune checkpoint inhibitor (ICI) therapy on survival outcomes in resectable non‐small cell lung cancer (NSCLC) patients who received neoadjuvant chemoimmunotherapy.MethodsA retrospective cohort study was conducted at Zhongshan Hospital, Fudan University, from January 2019 to June 2024, including resectable NSCLC patients treated with neoadjuvant chemotherapy combined with ICIs. Pathological responses were assessed, and event‐free survival (EFS) and overall survival (OS) were compared between patients who received postoperative adjuvant ICI therapy and those who did not.ResultsAmong the 186 patients included, 106 received adjuvant ICI therapy, while 80 did not. No significant differences in EFS or OS were observed between the two groups in patients who achieved pathological complete response (pCR) or major pathological response (MPR) (EFS: p = 0.282, OS: p = 0.330). In contrast, patients who did not achieve pCR or MPR experienced a significant improvement in EFS with adjuvant ICI therapy (p = 0.004). An AI‐based decision tree model developed to predict the need for postoperative adjuvant immunotherapy demonstrated strong performance, with an accuracy of 85% and an area under the curve (AUC) of 0.82. Key predictors identified by the model included pathological response, age, clinical stage, and PD‐L1 expression.ConclusionsPostoperative adjuvant ICI therapy significantly improves EFS in resectable NSCLC patients, especially in those without pCR or MPR. However, its effect on OS remains uncertain. These findings highlight the importance of personalized treatment strategies, with adjuvant ICI offering greater benefits for patients with incomplete pathological responses.