Ablation combined with video-assisted thoracic surgery hybrid technique for multiple primary lung cancer

Ruifeng Xu; Guochao Zhang; Yun Che; Na Ren; Shuaibo Wang; Chenglin Yang; Qi Xue; Fengwei Tan; Liang Zhao; Jie He

doi:10.1016/j.isci.2025.112703

Ablation combined with video-assisted thoracic surgery hybrid technique for multiple primary lung cancer

iScience. 2025 May 20;28(6):112703. doi: 10.1016/j.isci.2025.112703. eCollection 2025 Jun 20.

Authors

Ruifeng Xu¹, Guochao Zhang¹, Yun Che¹, Na Ren¹, Shuaibo Wang², Chenglin Yang³, Qi Xue¹, Fengwei Tan¹, Liang Zhao¹, Jie He¹

Affiliations

¹ 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 100021, China.
² Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
³ National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China.

Abstract

Increased public health awareness and expanded low-dose computed tomography (CT) utilization, accelerated by the COVID-19 pandemic, have elevated detection rates of pulmonary ground-glass nodules (GGNs). Patients with multiple primary lung cancer (MPLC) often present with multiple GGNs, posing challenges for precise treatment and prognostic assessment. Current therapies including stereotactic body radiation therapy (SBRT), chemotherapy, and immunotherapy face efficacy and safety limitations. While video-assisted thoracic surgery (VATS) is the primary treatment for high-risk GGNs, the sole reliance on surgery may cause excessive loss of lung function. Image-guided thermal ablation techniques can effectively treat smaller lesions with lung preservation. This review explores molecular mechanisms of ablation, VATS-ablation synergy, and the potential value of this approach in combination with immunotherapy. The clinical application prospects, including advancements in navigation techniques and equipment, are also discussed. Overall, this hybrid surgical strategy represents a promising option for patients with multiple lesions, minimizing lung function loss and the psychological burden.

Keywords: Cancer; Medical procedure; Surgery.

Publication types

Review