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Department of Thoracic Surgery

Shun-ichi Watanabe, Yukihiro Yoshida, Masaya Yotsukura, Yuma Fukumoto

Introduction

The Department of Thoracic Surgery deals with various kinds of neoplasms and allied diseases in the thorax, except the esophagus. These include both primary and metastatic lung tumors, mediastinal tumors, pleural tumors (mesotheliomas) and chest wall tumors. The main clinical activity of our department and the subject of most of its research activities has been the surgical management of patients with lung cancer.

The Team and What We Do

Our department has 4 attending surgeons and resident surgeons who perform all the inpatient care, surgeries, examinations, and outpatient care. In 2023, we performed a total of 746 operations, including lung cancer in 650, metastatic tumors in 11, mediastinal tumors in 45 and other tumors in 40 patients (Tables 1 and 2). The treatment strategy for patients with lung cancer is based on tumor histology (non-small cell vs. small cell), the extent of the disease (clinical stage) and the physical status of the patient. Surgical resection is usually indicated for clinical stages I, II and some III with non-small cell lung cancer [NSCLC] and clinical stage I with small cell lung cancer [SCLC] in patients with lung cancer. Whereas, to improve the poor prognosis of patients with clinically and histologically proven mediastinal lymph node metastasis or with invasion of vital neighboring structures, optimal treatment modalities are sought in a clinical trial setting. In addition, adjuvant therapy has often been given to patients with advanced lung cancer, even after complete resection. For metastatic lung tumors, resection has been attempted based on Thomford’s criteria. For mediastinal tumors, thymic epithelial tumors are most commonly encountered for resection. Meanwhile, treatment must be carefully determined by cytologic/histologic diagnosis preoperatively in the mediastinum, where various tumor histologies can arise. As for meetings, there are two department meetings. One is for the preoperative evaluation and postoperative inpatient review on Fridays and the other is for the journal club on Wednesdays.

Table 1. Details of resected disease

Primary lung cancer

650

Metastatic lung tumor

11

Mediastinal tumor

45

　Thymoma

28

　Thymic carcinoma

8

Malignant pleural mesothelioma

6

Others

34

Total

746

Table 2. Details of surgical procedures

Pulmonary resection

677

　Lobectomy

273

　Pneumonectomy

2

　Segmentectomy

269

　Wedge resection

133

Tracheal resection

1

Surgery for mediastinal tumors

46

Surgery for pleural tumors

9

Surgery for chest wall tumors

8

Others

5

Total

746

Research Activities

Lymph node dissection for lung cancer has been a major issue in lung cancer treatment and has been extensively studied in our department. We continue to improve our surgical dissection technique, taking oncological and surgical aspects into consideration: a more effective and less invasive lymph node dissection called “selective mediastinal/hilar dissection”, according to the primary tumor location by the lobe. Minimally invasive open surgery (MIOS) is also an important challenge in our department. Recently, the role of segmentectomy has become more important because of the increasing detection rate for early-stage NSCLC. We have actively performed segmentectomy in recent years. In 2023, we performed the largest number of segmentectomies as well as lung cancer surgeries in Japan.

Clinical Trials

Our department has played an important role as a leading hospital in the Japan Clinical Oncology Group (JCOG) - Lung Cancer Surgical Study Group (LCSSG). To date, the LCSSG has conducted a lot of clinical trials for lung cancer surgery.

With the increased frequency of the early detection rate of small-sized or ground-glass opacity (GGO) lung tumors, the optimal mode of resection: limited resection (segmentectomy and wedge resection) or standard resection (lobectomy) remains controversial. In addition, GGO tumors are well known to have an indolent behavior, thus some cases might be followed up with careful monitoring by CT. Accordingly, the best management of such patients not only with resection but also with observation needs to be explored. Three clinical trials to determine the appropriateness of limited resection for early stage NSCLC (JCOG0802, JCOG0804, and JCOG1211) have been conducted since the end of 2009. The results of these 3 trials were published, and the role of limited resection has been established. These 3 trials from the LCSSG could lead to major shifts in clinical practice towards limited resection for early-stage NSCLC. For GGO tumors, JCOG1906: a prospective evaluation of watchful waiting for early-stage lung cancer with GGO opened to accrual in June 2020.

Investigating the appropriate resection mode for compromised patients is also crucial. Three clinical trials are ongoing: JCOG1708, sublobar resection versus lobectomy for patients with resectable stage I NSCLC with idiopathic pulmonary fibrosis (opened to accrual in May 2018); JCOG1909, anatomical segmentectomy versus wedge resection in high-risk operable patients with clinical stage IA NSCLC (opened to accrual in April 2020); and JCOG2109, anatomical segmentectomy versus wedge resection for small (≤2 cm) peripheral NSCLC in 80 or more aged elderly patients (opened to accrual in October 2022). In addition, JCOG1710A, daily living activities in elderly patients who have undergone lung cancer surgery, completed the full accrual of 986 patients.

As for lymph node dissection, JCOG1413: lobe-specific versus systematic nodal dissection for c-stage I/II NSCLC, completed the full accrual of 1507 patients. We await the maturation of follow-up data.

Regarding adjuvant or neoadjuvant therapy, JCOG1916: postoperative radiotherapy for pathological N2 NSCLC with adjuvant chemotherapy opened to accrual in January 2021. Furthermore, JCOG1807C: efficacy and safety of durvalumab before and after operation or durvalumab as maintenance therapy after chemoradiotherapy against superior sulcus NSCLC opened to accrual in September 2020.

The relevance of postoperative follow-up and surveillance modalities remains debated after the NSCLC resection. JCOG2012: postoperative surveillance for pathological stage II-IIIA NSCLC opened to accrual in October 2022.

The LCSSG in the JCOG continues to establish ideal surgical treatment strategies for lung cancer.

List of papers published in 2023

Journal


1.       Yano K, Yotsukura M, Watanabe H, AkamineT, Yoshida Y, Nakagawa K, Yatabe Y, Kusumoto M, Watanabe SI. Oncological feasibility of segmentectomy for inner-located lung cancer. JTCVS Open, April 2024;18時26分1-275, Published:February 28, 2024DOI:https://doi.org/10.1016/j.xjon.2024.02.015.

2.       Detterbeck FC, Ostrowski M, Hoffmann H, Rami-Porta R, Osarogiagbon RU, Donnington J, Infante M, Marino M, Marom EM, Nakajima J, Nicholson AG, van Schil P, Travis WD, Tsao MS, Edwards JG, Asamura H; Members of the Staging and Prognostic Factors Committee and Advisory Boards.. The IASLC Lung Cancer Staging Project: Proposals for Revision of the Classification of Residual Tumor after Resection for the Forthcoming (9th) Edition of the TNM Classification of Lung Cancer. J Thorac Oncol. 2024 Apr 1:S1556-0864(24)00129-1. PMID:38569931, DOI: 10.1016/j.jtho.2024.03.021. Online ahead of print.

3.       Sakashita M, Motoi N, Yamamoto G, Gambe E, Suzuki M, Yoshida Y, Watanabe SI, Takazawa Y, Aoki K, Ochiai A, Sakashita S. An algorithm-based technique for counting mitochondria in cells using immunohistochemical staining of formalin-fixed and paraffin-embedded sections. J Cancer Res Clin Oncol. 2024 Apr 3;150(4):172. PMID: 38565653 DOI: 10.1007/s00432-024-05653-1.

4.       Gill RR, Nowak AK, Giroux DJ, Eisele M, Rosenthal A, Kindler H, Wolf A, Ripley RT, Billé A, Rice D, Opitz I, Rimner A, dePerrot M, Pass HI, Rusch VW; IASLC Staging and Prognostic Factors Committee; Advisory Boards and Participating Institution. The IASLC Mesothelioma Staging Project: Proposals for Revisions of the 'T' Descriptors in the Forthcoming 9th Edition of the TNM Classification for Pleural Mesothelioma. J Thorac Oncol. 2024 Mar 21:S1556-0864(24)00086-8. PMID:38521202, DOI: 10.1016/j.jtho.2024.03.007. Online ahead of print.

5.       Takasawa K, Asada K, Kaneko S, Shiraishi K, Machino H, Takahashi S, Shinkai N, Kouno N, Kobayashi K, Komatsu M, Mizuno T, Okubo Y, Mukai M, Yoshida T, Yoshida Y, Horinouchi H, Watanabe SI, Ohe Y, Yatabe Y, Kohno T, Hamamoto R. Advances in cancer DNA methylation analysis with methPLIER: use of non-negative matrix factorization and knowledge-based constraints to enhance biological interpretability. Exp Mol Med. 2024 Mar;56(3):646-655. doi: 10.1038/s12276-024-01173-7. Epub 2024 Mar 4. PMID: 38433247, PMCID: PMC10985003 DOI: 10.1038/s12276-024-01173-7.

6.       Fukuda H, Arai K, Mizuno H, Nishito Y, Motoi N, Arai Y, Hiraoka N, Shibata T, Sonobe Y, Kayukawa Y, Hashimoto E, Takahashi M, Fujii E, Maruyama T, Kuwabara K, Nishizawa T, Mizoguchi Y, Yoshida Y, Watanabe SI, Yamashita M, Kitano S, Sakamoto H, Nagata Y, Mitsumori R, Ozaki K, Niida S, Kanai Y, Hirayama A, Soga T, Tsukada K, Yabuki N, Shimada M, Kitazawa T, Natori O, Sawada N, Kato A, Yoshida T, Yasuda K, Ochiai A, Tsunoda H, Aoki K. Molecular subtypes of lung adenocarcinoma present distinct immune tumor microenvironments. Cancer Sci. 2024 Mar 25. doi: 10.1111/cas.16154. Online ahead of print. PMID: 38527308 DOI: 10.1111/cas.16154.

7.       Rami-Porta R, Nishimura KK, Giroux DJ, Detterbeck F, Cardillo G, Edwards JG, Fong KM, Giuliani M, Huang J, Kernstine KH Sr, Marom EM, Nicholson AG, Van Schil PE, Travis WD, Tsao MS, Watanabe SI, Rusch VW, Asamura H; Members of the IASLC Staging and Prognostic Factors Committee and of the Advisory Boards, and Participating Institutions. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groups in the Forthcoming (Ninth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2024 Mar 4:S1556-0864(24)00079-0. PMID:38447919. DOI: 10.1016/j.jtho.2024.02.011 . Online ahead of print.

8.       Mochizuki A, Shiraishi K, Honda T, Higashiyama RI, Sunami K, Matsuda M, Shimada Y, Miyazaki Y, Yoshida Y, Watanabe SI, Yatabe Y, Hamamoto R, Kohno T. Passive Smoking-Induced Mutagenesis as a Promoter of Lung Carcinogenesis. J Thorac Oncol. 2024 Feb 19:S1556-0864(24)00074-1. doi: 10.1016/j.jtho.2024.02.006. Online ahead of print. PMID: 38382595 DOI: 10.1016/j.jtho.2024.02.006.

9.       Shiraishi K, Takahashi A, Momozawa Y, Daigo Y, Kaneko S, Kawaguchi T, Kunitoh H, Matsumoto S, Horinouchi H, Goto A, Honda T, Shimizu K, Torasawa M, Takayanagi D, Saito M, Saito A, Ohe Y, Watanabe SI, Goto K, Tsuboi M, Tsuchihara K, Takata S, Aoi T, Takano A, Kobayashi M, Miyagi Y, Tanaka K, Suzuki H, Maeda D, Yamaura T, Matsuda M, Shimada Y, Mizuno T, Sakamoto H, Yoshida T, Goto Y, Yoshida T, Yamaji T, Sonobe M, Toyooka S, Yoneda K, Masago K, Tanaka F, Hara M, Fuse N, Nishizuka SS, Motoi N, Sawada N, Nishida Y, Kumada K, Takeuchi K, Tanno K, Yatabe Y, Sunami K, Hishida T, Miyazaki Y, Ito H, Amemiya M, Totsuka H, Nakayama H, Yokose T, Ishigaki K, Nagashima T, Ohtaki Y, Imai K, Takasawa K, Minamiya Y, Kobayashi K, Okubo K, Wakai K, Shimizu A, Yamamoto M, Iwasaki M, Matsuda K, Inazawa J, Shiraishi Y, Nishikawa H, Murakami Y, Kubo M, Matsuda F, Kamatani Y, Hamamoto R, Matsuo K, Kohno T. Identification of telomere maintenance gene variations related to lung adenocarcinoma risk by genome-wide association and whole genome sequencing analyses. Cancer Commun (Lond). 2024 Feb;44(2):287-293. PMID: 37882647 PMCID: PMC10876189 DOI: 10.1002/cac2.12498 Epub 2023 Oct 26.

10.   Takamori S, Yatabe Y, Osoegawa A, Aokage K, Yoshioka H, Miyoshi T, Mimae T, Endo M, Hattori A, Yotsukura M, Isaka T, Isaka M, Maniwa T, Nakajima R, Watanabe SI. Rare but clinically important salivary gland-type tumor of the lung: A review. Jpn J Clin Oncol. 2024 Feb 7;54(2):121-128. PMID: 37952098 DOI: 10.1093/jjco/hyad154.

11.   Kobayashi K, Gu L, Hataya R, Mizuno T, Miyake M, Watanabe H, Takahashi M, Takamizawa Y, Yoshida Y, Nakamura S, Kouno N, Bolatkan A, Kurose Y, Harada T, Hamamoto R. Sketch-based semantic retrieval of medical images. Med Image Anal. 2024 Feb;92:103060. doi: 10.1016/j.media.2023.103060. Epub 2023 Dec 8.

12.   Mochizuki A, Shiraishi K, Honda T, Higashiyama RI, Sunami K, Matsuda M, Shimada Y, Miyazaki Y, Yoshida Y, Watanabe SI, Yatabe Y, Hamamoto R, Kohno T. Passive Smoking-Induced Mutagenesis as a Promoter of Lung Carcinogenesis. J Thorac Oncol. 2024 Feb 19:S1556-0864(24)00074-1.

13.   Sugawara H, Kikkawa N, Ito K, Watanabe H, Kaku S, Akai H, Abe O, Watanabe SI, Yatabe Y, Kusumoto M. Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer. Br J Radiol. 2024 Feb 2;97(1154):462-468. PMID:38308036, DOI: 10.1093/bjr/tqad048.

14.   Akamine T, Nakagawa K, Ito K, Watanabe H, Yotsukura M, Yoshida Y, Yatabe Y, Kusumoto M, Watanabe SI. ASO Visual Abstract: Impact of 18F-FDG PET on TNM Staging and Prognosis in Thymic Epithelial Tumors. Ann Surg Oncol 2024 Feb;31(2):1146-1147. PMID: 37843666 DOI: 10.1245/s10434-023-14391-6.

15.   Hattori A, Suzuki K, Takamochi K, Wakabayashi M, Sekino Y, Tsutani Y, Nakajima R, Aokage K, Saji H, Tsuboi M, Okada M, Asamura H, Nakamura K, Fukuda H, Watanabe SI; Japan Clinical Oncology Group; West Japan Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer with radiologically pure-solid appearance in Japan (JCOG0802/WJOG4607L): a post-hoc supplemental analysis of a multicentre, open-label, phase 3 trial. Lancet Respir Med. 2024 Feb;12(2):105-116. PMID: 38184010 DOI: 10.1016/S2213-2600(23)00382-X. Epub 2024 Jan 3.

16.   Ohashi K, Nishito Y, Fukuda H, Sadahiro R, Yoshida Y, Watanabe SI, Motoi N, Sonobe Y, Mizuno H, Tsunoda H, Tatsumi K, Suzuki T, Ochiai A, Aoki K. Neutrophil-to-lymphocyte ratio is a prognostic factor reflecting immune condition of tumor microenvironment in squamous cell lung cancer. Sci Rep. 2024 Jan 3;14(1):429. PMID:38172491. PMCID:PMC10764784. DOI: 10.1038/s41598-023-50378-9.

17.   Akamine T, Nakagawa K, Ito K, Watanabe H, Yotsukura M, Yoshida Y, Yatabe Y, Kusumoto M, Watanabe SI. Impact of 18F-FDG PET on TNM Staging and Prognosis in Thymic Epithelial Tumors. Ann Surg Oncol. 2024 Jan;31(1):192-200. PMID: 37743455 DOI: 10.1245/s10434-023-14328-z. Epub 2023 Sep 25.

18.   Adachi H, Morohoshi T, Shintani Y, Okami J, Ito H, Ohtsuka T, Mori T, Watanabe SI, Chida M, Endo S, Nakanishi R, Kadokura M, Suzuki H, Miyaoka E, Yoshino I, Date H; Japanese Joint Committee of Lung Cancer Registry. Benefit of Adjuvant Chemotherapy for Patients Older Than 75 Years With Completely Resected p-Stage II-IIIA Non-Small-Cell Lung Cancer: A Retrospective Cohort Study Using Japanese Nationwide Real-World Data. Clin Lung Cancer. 2024 Jan;25(1):61-71.e1. PMID: 37914595 DOI: 10.1016/j.cllc.2023.10.001. Epub 2023 Oct 12.

19.   Adachi H, Saito A, Shintani Y, Okami J, Ito H, Ohtsuka T, Mori T, Watanabe SI, Chida M, Endo S, Nakanishi R, Kadokura M, Suzuki H, Miyaoka E, Yoshino I, Date H, Japanese Joint Committee Of Lung Cancer Registry. Is adjuvant chemotherapy for completely resected p-stage IA (>2 cm) and stage IB non-small-cell lung cancer beneficial for elderly patients? A large, retrospective cohort study based on real-world data from Japan. Jpn J Clin Oncol. 2023 Dec 7;53(12):1191-1200. PMID: 37626449 DOI: 10.1093/jjco/hyad116.

20.   Shirasawa M, Yoshida T, Shiraishi K, Goto N, Yagishita S, Imabayashi T, Matsumoto Y, Masuda K, Shinno Y, Okuma Y, Goto Y, Horinouchi H, Yotsukura M, Yoshida Y, Nakagawa K, Naoki K, Tsuchida T, Hamamoto R, Yamamoto N, Motoi N, Kohno T, Watanabe SI, Ohe Y. Tumor microenvironment-mediated immune profiles and efficacy of anti-PD-L1 antibody plus chemotherapy stratified by DLL3 expression in small-cell lung cancer. Br J Cancer. 2023 Dec;129(12):2003-2013. PMID: 37731022. PMCID: PMC10703835 (available on 2024-09-20). DOI: 10.1038/s41416-023-02427-3. Epub 2023 Sep 20.

21.   Haga Y, Sakamoto Y, Kajiya K, Kawai H, Oka M, Motoi N, Shirasawa M, Yotsukura M, Watanabe SI, Arai M, Zenkoh J, Shiraishi K, Seki M, Kanai A, Shiraishi Y, Yatabe Y, Matsubara D, Suzuki Y, Noguchi M, Kohno T, Suzuki A. Whole-genome sequencing reveals the molecular implications of the stepwise progression of lung adenocarcinoma. Nat Commun. 2023 Dec 15;14(1):8375. PMID: 38102134 PMCID: PMC10724178 DOI: 10.1038/s41467-023-43732-y.

22.   Miyoshi T, Ito H, Wakabayashi M, Hashimoto T, Sekino Y, Suzuki K, Tsuboi M, Moriya Y, Yoshino I, Isaka T, Hattori A, Mimae T, Isaka M, Maniwa T, Endo M, Yoshioka H, Nakagawa K, Nakajima R, Tsutani Y, Saji H, Okada M, Aokage K, Fukuda H, Watanabe SI. Risk factors for loss of pulmonary function after wedge resection for peripheral ground-glass opacity dominant lung cancer. Eur J Cardiothorac Surg. 2023 Dec 1;64(6):ezad365. PMID: 37930048 DOI: 10.1093/ejcts/ezad365.

23.   Muraoka Y, Yotsukura M, Yoshida Y, Nakagawa K, Shiraishi K, Kohno T, Yatabe Y, Watanabe SI. Dynamics of recurrence after curative resection of nonsmall cell lung cancer. J Surg Oncol. 2023 Dec;128(7):1205-1212. PMID: 37458135 DOI: 10.1002/jso.27395.

24.   Maniwa T, Okami J, Miyoshi T, Wakabayashi M, Yoshioka H, Mimae T, Endo M, Hattori A, Nakagawa K, Isaka T, Isaka M, Kita R, Sekino Y, Mitome N, Aokage K, Saji H, Nakajima R, Okada M, Tsuboi M, Asamura H, Fukuda H, Watanabe SI; West Japan Oncology Group; Japan Clinical Oncology Group. Lymph node dissection in small peripheral lung cancer: supplemental analysis of JCOG0802/WJOG4607L. J Thorac Cardiovasc Surg. 2023 Nov 22:S0022-5223(23)01099-1. PMID:38000629. DOI: 10.1016/j.jtcvs.2023.11.023. Online ahead of print.

25.   Mimae T, Wakabayashi M, Sano Y, Sekino Y, Aokage K, Okada M, Watanabe SI, Saji H, the Lung Cancer Surgical Study Group/Japan Clinical Oncology Group. Anatomical segmentectomy versus wedge resection for small (≤2 cm) peripheral non-small cell lung cancer in 80 or more aged elderly patients: a randomized phase III study (JCOG2109, AWESOME). Japanese Journal of Clinical Oncology. 2023 Nov;53(11) : 1077–1081.

26.   Okumura M, Yoshino I, Funaki S, Okuda K, Watanabe SI, Tsuboi M, Shimizu K, Date H, Chen-Yoshikawa TF, Nakajima J, Toyooka S, Asamura H. Long-term outcomes following surgical treatment for thymic epithelial tumor in Japan and an analysis of prognostic factors based on the Japanese Association for Research on the Thymus nationwide database. Surg Today. 2023 Nov;53(11):1247-1259. PMID: 37460670. DOI: 10.1007/s00595-023-02705-w. Epub 2023 Jul 17.

27.   Matsuura Y, Mun M, Shintani Y, Okami J, Ito H, Ohtsuka T, Mori T, Watanabe SI, Chida M, Endo S, Nakanishi R, Kadokura M, Suzuki H, Miyaoka E, Yoshino I, Date H; Japanese Joint Committee of Lung Cancer Registry. Features of anaplastic lymphoma kinase rearrangement in early-stage lung cancer: Analysis of a nationwide Japanese database. J Surg Oncol. 2023 Oct;128(5):916-924. PMID: 37403534. DOI: 10.1002/jso.27384. Epub 2023 Jul 5.

28.   Yoshino I, Moriya Y, Suzuki K, Wakabayashi M, Saji H, Aokage K, Suzuki M, Ito H, Matsumoto I, Kobayashi M, Okamoto T, Okada M, Yamashita M, Ikeda N, Nakamura S, Kataoka T, Tsuboi M, Watanabe SI; West Japan Oncology Group and Japan Clinical Oncology Group. Long-term outcome of patients with peripheral ground-glass opacity-dominant lung cancer after sublobar resections. J Thorac Cardiovasc Surg. 2023 Oct;166(4):1222-1231.e1. PMID: 37704343 DOI: 10.1016/j.jtcvs.2023.01.019.

29.   Igarashi T, Mazevet M, Yasuhara T, Yano K, Mochizuki A, Nishino M, Yoshida T, Yoshida Y, Takamatsu N, Yoshimi A, Shiraishi K, Horinouchi H, Kohno T, Hamamoto R, Adachi J, Zou L, Shiotani B. An ATR-PrimPol pathway confers tolerance to oncogenic KRAS-induced and heterochromatin-associated replication stress. Nat Commun. 2023 Aug 17;14(1):4991.

30.   Takei H, Kunitoh H, Wakabayashi M, Kataoka T, Sekino Y, Mizutani T, Tsuboi M, Ikeda N, Asamura H, Okada M, Takahama M, Ohde Y, Okami J, Shiono S, Aokage K, Watanabe SI; Lung Cancer Surgical Study Group of the Japan Clinical Oncology Group, Japan. Prospective, Multi-Institutional Observational Study of Deterioration in Activities of Daily Living in Elderly Patients After Lung Cancer Surgery. JTO Clin Res Rep. 2023 Jul 17;4(8):100550. PMID: 37600227. PMCID: PMC10432798. DOI: 10.1016/j.jtocrr.2023.100550. eCollection 2023 Aug.

31.   Aoki K, Nishito Y, Motoi N, Arai Y, Hiraoka N, Shibata T, Sonobe Y, Kayukawa Y, Hashimoto E, Takahashi M, Fujii E, Nishizawa T, Fukuda H, Ohashi K, Arai K, Mizoguchi Y, Yoshida Y, Watanabe SI, Yamashita M, Kitano S, Sakamoto H, Nagata Y, Mitsumori R, Ozaki K, Niida S, Kanai Y, Hirayama A, Soga T, Maruyama T, Tsukada K, Yabuki N, Shimada M, Kitazawa T, Natori O, Sawada N, Kato A, Yoshida T, Yasuda K, Mizuno H, Tsunoda H, Ochiai A. Tumor-infiltrating Leukocyte Profiling Defines Three Immune Subtypes of NSCLC with Distinct Signaling Pathways and Genetic Alterations. Cancer Res Commun. 2023 Jun 13;3(6):1026-1040. PMID: 37377611. PMCID: PMC10263066. DOI: 10.1158/2767-9764.CRC-22-0415. eCollection 2023 Jun.

32.   Adachi M, Matsumoto Y, Furuse H, Uchimura K, Imabayashi T, Yotsukura M, Yoshida Y, Nakagawa K, Igaki H, Watanabe SI, Tsuchida T. Utility of the endobronchial Watanabe spigot for intractable cancer-related pneumothorax: a retrospective observational study. Jpn J Clin Oncol. 2023 Aug 30;53(9):829-836. PMID: 37340759. PMCID: PMC10473273. DOI: 10.1093/jjco/hyad060.

33.   Aokage K, Suzuki K, Saji H, Wakabayashi M, Kataoka T, Sekino Y, Fukuda H, Endo M, Hattori A, Mimae T, Miyoshi T, Isaka M, Yoshioka H, Nakajima R, Nakagawa K, Okami J, Ito H, Kuroda H, Tsuboi M, Okumura N, Takahama M, Ohde Y, Aoki T, Tsutani Y, Okada M, Watanabe SI; Japan Clinical Oncology Group. Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): a multicentre, single-arm, confirmatory, phase 3 trial. Lancet Respir Med. Lancet Respir Med. 2023 Jun;11(6):540-549. PMID: 36893780. DOI: 10.1016/S2213-2600(23)00041-3.

34.   Asamura H, Nishimura KK, Giroux DJ, Chansky K, Hoering A, Rusch V, Rami-Porta R; Members of the IASLC Staging and Prognostic Factors Committee and of the Advisory Boards, and Participating Institutions. IASLC Lung Cancer Staging Project: The New Database to Inform Revisions in the Ninth Edition of the TNM Classification of Lung Cancer. J Thorac Oncol. 2023 May;18(5):564-575. PMID: 36773775. DOI: 10.1016/j.jtho.2023.01.088.

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