Since the late 20th century, Chinese medicine has developed rapidly in comparison to the rest of the world, being China one of the countries which have made more significant advances in medical research and treatments. Aiming to provide a comprehensive, in-depth look at how Chinese medicine is practiced and examine its impact on global health, we are proud to introduce Meet the Masters, as part of the Healing in China series, which brings together the best Chinese KOLs and top surgeons from other regions of the world to guide you through their surgeries and transfer years of knowledge. In this event, AIS Channel specially invites top thoracic surgery experts from China, the United Kingdom and the United States to share academic insights on lobectomy after neoadjuvant therapy. This event features operation videos, case sharing, and interactive discussions to enhance surgical skills and improve global standards in this field.
Program
Clinical Background
Hospital/Department Introduction
Welcome and Introduction – Dr. Di Ge (China)
Case Introduction – Dr. Di Ge (China)
Lobectomy After Neoadjuvant Therapy. Part 1 – Dr. Di Ge (China)
Technique Description
Key Decision 1 Question – Dr. Alessandro Brunelli (UK) and Dr. Di Ge (China)
Lobectomy After Neoadjuvant Therapy. Part 2 – Dr. Di Ge (China)
Key Decision 2 Question – Dr. Douglas E. Wood (USA) and Dr. Di Ge (China)
Lobectomy After Neoadjuvant Therapy. Part 3 – Dr. Di Ge (China)
Key Decision 3 Question – Dr. Alessandro Brunelli (UK) and Dr. Di Ge (China)
Lobectomy After Neoadjuvant Therapy. Part 4 – Dr. Di Ge (China)
Key Decision 4 Question – Dr. Douglas E. Wood (USA) and Dr. Di Ge (China)
Panel Discussion - All faculty moderated by Dr. Di Ge (China)
Clinical case
Clinical history
Male, 65 years old
Found an occupying lesion in the right upper lobe 2 months ago
History: NS
Physical Examination: (-)
Pulmonary function:
-FEV1 : 2.04L,
-FEV1%: 81.34% of predicted value
EKG: (-)
PET/CT Scan
Aug 1st, 2022
A peripheral lesion in the right upper lobe with a Max SUV value of 24.4, invading the adjacent mediastinal pleura, with possible metastasis to the lymph nodes station 4R.
Bronchoscopy + EBUS-TBNA（Lymph node station 4R)
Aug 3rd, 2022
Lymph node station 4R: Squamous cell carcinoma (Low differentiation)
-PD-L1 (28-8) (tumor -, 5% interstitial, TPS=0, CPS=5);
-PD-L1 (E1L3N) (tumor -, 5% interstitial, TPS=0, CPS=5)
Clinical Staging: cT3N2M0, IIIB - Preoperative Treatment (MDT)
Neoadjuvant Chemotherapy +ICIs based on III clinical studies Checkmate816
Treatment date: Aug 12th, Sep 2th, Sep 27th, 2022
Treatment plan: Albumin paclitaxel 440mg d1 + Carboplatin 435mg d1 + Nivolumab 200mg d1 q3w
Adverse reaction: Transient leukopenia occurred during the 2nd course of treatment, but was cured promptly was no delay in the subsequent treatment
Radiological outcome: Partial Response (PR)
Date of Operation: Oct 18th, 2022
VATS lobectomy of RUL
Wedge resection of RLL
Systemic dissection of mediastinal lymph node
Pathologic outcomes
No squamous cell carcinoma tissue
A small amount of adenocarcinoma tissue, acinar type, grade II, accounted for 5% of the tumor bed
Bronchial margin (-)
Lymph nodes (-)
Major Pathological Response (MPR), Downstage
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