30-Second Takeaway
- Perioperative chemoimmunotherapy improves pathological response and survival in resectable NSCLC versus chemotherapy alone.
- Robotic-assisted esophagectomy (RAMIE) shows lower major bleeding and favorable cost-effectiveness versus open and conventional MIE.
- Machine-learning models outperform traditional cardiac risk scores but lack external validation for routine use.
Week ending June 27, 2026
Selected recent evidence affecting thoracic surgical practice
Perioperative chemoimmunotherapy increases survival and pathological response in resectable NSCLC.
Systematic review of 16 studies (n=4,646) found higher survival and pathological response with perioperative immunotherapy plus chemotherapy versus chemotherapy alone. The pooled data consistently favored combined therapy for pathological response rates across heterogeneous trials. The combined approach was associated with a trend toward increased treatment-related adverse events. Heterogeneity in study designs and endpoints limits precise effect-size estimates and direct protocol translation.
Continuous serratus anterior plane block reduced early opioid use but did not improve QoR-40 after VATS.
In a double-blind RCT of 173 VATS patients, continuous SAPB did not significantly improve QoR-40 on postoperative day 1. SAPB reduced opioid consumption in recovery (8.0 vs 10.6 IV MME) and on POD1 (12.7 vs 16.5 IV MME). Pain scores, complications, and 30-day readmissions were similar between SAPB and placebo. Observed secondary benefits should be considered exploratory pending larger confirmatory trials.
Neoadjuvant chemoimmunotherapy followed by surgery is feasible with high R0 and substantial pathological responses.
Single-center retrospective cohort of 30 locally advanced NSCLC patients showed 83.3% proceeded to surgery after neoadjuvant chemoimmunotherapy. Complete (R0) resection was achieved in 96%, with major pathological response in 52% and pCR in 36%. Postoperative complications occurred in 56%, mostly Clavien-Dindo I–II, and there was one postoperative death. Surgery was often technically demanding (adhesions, hilar fibrosis) but had low conversion and acceptable perioperative safety in this series.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.