Background: Reports of comparison between robotic and thoracoscopic surgery for lung cancer are limited, we aimed to compare the perioperative outcomes of robotic and thoracoscopic anatomic pulmonary resection for lung cancer. 50.3±37.9 mL, P=0.531), morbidity rates (42.0% vs. 30.4%, P=0.157) were similar between the robotics and thoracoscopy. However, robotics was associated with higher cost ($12,067±1,610 vs. $8,328±1,004, P<0.001), and longer operative time (136±40 vs. 111±28 min, P<0.001). Conclusions: Robotics seems to have higher hospital costs and longer operative time, without superior advantages in morbidity rates and oncologic efficiency. Further prospective randomized clinical trials were needed to validate both of its short-and long-term oncologic efficiency.

Ricolinostat (ACY-1215), a first-in-class selective HDAC6 inhibitor, exhibits antitumor effects alone or in combination with other drugs in various cancers. However, its efficacy in esophageal cancer remains unclear. In this study, we found that the high expression of HDAC6 was associated with poor prognosis in esophageal squamous cell carcinoma (ESCC) tissues. Then, we identified that ACY-1215 significantly inhibited cellular proliferation in ESCC, and caused G2/M phase arrest and apoptosis. We further demonstrated that ACY-1215 treatment reduced the expression of PI3K, P-AKT, P-mTOR, and P-ERK1/2 and increased that of Ac-H3K9 and Ac-H4K8. In addition, using miRNA microarray and bioinformatics analysis, we detected that ACY-1215 promoted miR-30d expression, and PI3K regulatory subunit 2 (PIK3R2) was a direct target of miR-30d. Anti-miR-30d partially rescued the G2/M phase arrest and apoptosis caused by ACY-1215 treatment. The reductions in PI3K, P-AKT, and P-mTOR expression were also partially reversed by miR-30d inhibitor. Furthermore, the effects of ACY-1215 inhibited ESCC proliferation were validated in a mouse xenograft model in vivo. In conclusion, our study showed that ACY-1215 suppressed proliferation and promoted apoptosis in ESCC via miR-30d/PI3K/AKT/mTOR and ERK pathways and that ACY-1215 may be a promising antitumor agent in ESCC.

This propensity score-matched analysis reveals an association of LN dissection, particularly more extensive regional LN dissection (≥4 regional LNs), with better survival rates in patients who undergo sublobar resection for stage IA NSCLC tumors ≤2 cm.

Background: Pulmonary nodular lymphoid hyperplasia (PNLH) is a rare benign disease lacking systematically clinical assessment. This study aims to explore the clinical features of PNLH and evaluate the safety and efficacy of different surgical approaches for PNLH. Methods: Patients with confirmed PNLH in our department between March 2007 and August 2017 were retrospectively reviewed. The detail information of patients, including demographic characteristics, medical history, preoperative investigations, perioperative findings, postoperative conditions, and recurrence status, was collected and analyzed. Results: A total of 67 patients with PNLH were diagnosed in our department, and 15 of them were suspected to have lung cancer by radiological examination before the surgery. 43 of 67 patients underwent sublobar resection and 24 patients underwent lobectomy. Compared with the lobectomy, sublobar resection showed more significant advantages in operation time (P<0.001), blood loss (P=0.001), volume of chest drainage (P=0.007), duration of chest drainage (P=0.001) and postoperative hospital stay (P=0.001). Conclusions: The diagnosis of PNLH before operation is challenging and it should be taken into consideration in the differential diagnosis of lung nodules. Compared with lobectomy, sublobar resection is an alternative approach for the treatment of PNLH.

This study aimed to semi-quantitatively evaluate the elastographic imaging color distribution of mediastinal and hilar lymph nodes (LNs), and explored its utility in helping define malignant and benign LNs for lung cancer patients. We prospectively collected patients who underwent preoperative mediastinal staging of suspected lung cancer by EBUS-TBNA. We analyzed the elastography color distribution of each LN and calculated the blue color proportion (BCP). The LN elastographic patterns were compared with the final EBUS-TBNA pathological results. A receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic value of BCP. We sampled and analyzed 79 LNs from 60 patients. The average BCP in malignant LNs was remarkably higher than that in benign LNs (57.1% versus 30.8%, P < 0.001). The area under the ROC curve (AUC) for the BCP was 0.86 (95% CI: 0.78–0.94). The best cutoff BCP for differentiating between benign and malignant LNs was determined as 36.7%. All the 16 LNs (20.3%) with a BCP lower than 27.9% were diagnosed as benign tissues. Our study suggests that elastography is a feasible technique that may safely help to predict LN metastasis during EBUS-TBNA. We found a clear BCP cutoff value to help define positive and negative LNs.