Ep. 40 Advanced Surgical Approaches in Lung Cancer Management with Dr. Scott Atay and Dr. Scott Oh

Is the open thoracotomy becoming outdated as robotic surgery and advanced ablation techniques take center stage in lung cancer treatment? In the final discussion of the 2025 NSCLC Creator Weekend™ series, our virtual tumor board of interventional radiologists and pulmonologists from leading medical institutions discuss recent surgical and interventional advancements in the treatment of lung cancer.

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This podcast is supported by an educational grant from Johnson & Johnson and Varian.

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SYNPOSIS

The conversation covers the contemporary role of PET scans, endobronchial ultrasound (EBUS), mediastinal staging, and the importance of perioperative systemic therapy. The doctors explore surgical and non-surgical methods for treating lung cancer, including lymph node dissection, criteria for resection, and the advantages of minimally invasive approaches such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgeries.

A key focus of this episode is the decision-making process for treating multifocal lung cancers while preserving lung function, and the use of combined therapies like ablation and radiation. The episode concludes with a detailed case study illustrating the long-term management of a patient with multiple lung adenocarcinomas over several years, highlighting the multidisciplinary approach required in such complex scenarios.

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TIMESTAMPS

00:00 - Introduction
10:07 - Patient Selection and Comorbid Conditions
27:29 - Surgical Margins and Resection Strategies
42:11 - Understanding Upstaging in Cancer Treatment
53:27 - Technical and Clinical Resectability
56:13 - Case Study: Managing Multifocal Lung Cancer
01:11:41 - Long-Term Outcomes and Treatment Strategies

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RESOURCES

CALGB 140503 Trial
https://www.nejm.org/doi/full/10.1056/NEJMoa2212083

JCOG0802 Trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/abstract