Pub Date : 2025-09-18DOI: 10.1016/j.jtocrr.2025.100906
Viviane Teixeira Loiola de Alencar MD, PhD candidate , Felipe Navarro Balbino Alves BSc, MSc , Guilherme de Souza Velozo BSc, MSc , Luiz Edmundo Lopes Mizutani BSc, MSc , Iusta Caminha MD, MSc, PhD candidate , Gabriel Barbosa Silva BSc in Biomedical Science , Vladmir Cláudio Cordeiro de Lima MD, PhD , Fábio Rocha Fernandes Távora MD, PhD
Introduction
Lung cancer is the leading cause of cancer-related deaths worldwide, with accurate histologic subtype classification critical for diagnosis and treatment planning. Diagnostic variability and resource disparities, particularly in underrepresented regions such as Latin America, pose substantial challenges. This study developed and evaluated novel artificial intelligence models trained on both global and Latin American pathology samples for subtype classification of hematoxylin and eosin (HE)–stained whole-slide images (WSIs).
Methods
Two DinoV2-based feature extractors, LungDino and OncoDino, trained on large data sets for task-specific and general pathology applications, were developed. The training data set consisted of 1308 HE-stained WSIs, including 412 adenocarcinomas, 323 squamous cell carcinomas, 41 small cell carcinomas, and 532 benign tissue samples, sourced from The Cancer Genome Atlas and an in-house Latin American data set. A ResNet model trained on ImageNet served as the baseline. Models were evaluated on 79 Latin American WSIs using receiver operating characteristic curves, and heatmaps were generated for tumor localization.
Results
The DinoV2-based models outperformed the ResNet baseline. LungDino achieved the highest overall performance, with area under the curves of 0.97 for adenocarcinoma and 0.96 for squamous cell carcinoma. OncoDino excelled in underrepresented categories, achieving an area under the curve of 0.99 for small cell carcinoma, demonstrating its generalizability. Both models generated interpretable heatmaps, with LungDino demonstrating precise tumor localization. In the subset of samples classified as poorly differentiated or undifferentiated in HE pathology reports, the DinoV2 models also maintained high classification performance.
Conclusion
These findings underscore the effectiveness of task-specific and general feature extractors in delivering accurate, explainable results and address a gap in artificial intelligence–driven histopathology advancements, paving the way for future clinical applications.
{"title":"Machine Learning Models Using General and Tissue-Specific Feature Extractors for Accurate Subtyping of Biopsy Samples: Advancing Lung Cancer Diagnosis in Latin America","authors":"Viviane Teixeira Loiola de Alencar MD, PhD candidate , Felipe Navarro Balbino Alves BSc, MSc , Guilherme de Souza Velozo BSc, MSc , Luiz Edmundo Lopes Mizutani BSc, MSc , Iusta Caminha MD, MSc, PhD candidate , Gabriel Barbosa Silva BSc in Biomedical Science , Vladmir Cláudio Cordeiro de Lima MD, PhD , Fábio Rocha Fernandes Távora MD, PhD","doi":"10.1016/j.jtocrr.2025.100906","DOIUrl":"10.1016/j.jtocrr.2025.100906","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer-related deaths worldwide, with accurate histologic subtype classification critical for diagnosis and treatment planning. Diagnostic variability and resource disparities, particularly in underrepresented regions such as Latin America, pose substantial challenges. This study developed and evaluated novel artificial intelligence models trained on both global and Latin American pathology samples for subtype classification of hematoxylin and eosin (HE)–stained whole-slide images (WSIs).</div></div><div><h3>Methods</h3><div>Two DinoV2-based feature extractors, LungDino and OncoDino, trained on large data sets for task-specific and general pathology applications, were developed. The training data set consisted of 1308 HE-stained WSIs, including 412 adenocarcinomas, 323 squamous cell carcinomas, 41 small cell carcinomas, and 532 benign tissue samples, sourced from The Cancer Genome Atlas and an in-house Latin American data set. A ResNet model trained on ImageNet served as the baseline. Models were evaluated on 79 Latin American WSIs using receiver operating characteristic curves, and heatmaps were generated for tumor localization.</div></div><div><h3>Results</h3><div>The DinoV2-based models outperformed the ResNet baseline. LungDino achieved the highest overall performance, with area under the curves of 0.97 for adenocarcinoma and 0.96 for squamous cell carcinoma. OncoDino excelled in underrepresented categories, achieving an area under the curve of 0.99 for small cell carcinoma, demonstrating its generalizability. Both models generated interpretable heatmaps, with LungDino demonstrating precise tumor localization. In the subset of samples classified as poorly differentiated or undifferentiated in HE pathology reports, the DinoV2 models also maintained high classification performance.</div></div><div><h3>Conclusion</h3><div>These findings underscore the effectiveness of task-specific and general feature extractors in delivering accurate, explainable results and address a gap in artificial intelligence–driven histopathology advancements, paving the way for future clinical applications.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100906"},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-18DOI: 10.1016/j.jtocrr.2025.100910
Sindhu Bhaarrati Naidu M.B.B.S. , Allegra Wisking BSc , Akul Karoshi BSc , Sarah Burdett MSc , Peter J. Godolphin PhD , Sanjay Popat PhD , OLIVE PPI Group, Sam M. Janes PhD , Neal Navani PhD
Objectives
Lung cancer is the leading cause of cancer mortality globally. Although often associated with smoking, up to 25% of cases worldwide and 50% in East Asia occur in “never-smokers.” There are currently no robust tools for predicting lung cancer in individuals who have never smoked (LCINS) for populations outside East Asia.
Together with a group of patient representatives, the authors of this study aimed to summarise risk factors for LCINS and quantify risk in different geographical regions.
Methods
This study was prospectively registered (PROSPERO-CRD42022379253). The systematic review and meta-analysis included studies published from 2017 and aimed to comprehensively investigate risk factors associated with LCINS incidence. Risk of bias was assessed using Newcastle-Ottawa Scale.
Results
A total of 6725 reports were identified and 54 studies were included, with multivariable analysis of 192 factors in 16 million never-smokers. No studies were assessed as having high risk of bias. Of the participants, 8,241,269 (51.0%) were from Western countries.
The meta-analysis found that female sex (adjusted hazard ratio [aHR] 1.28 [95% confidence interval or CI 1.12–1.47]), previous cancer (aHR 2.04 [1.95–2.13]), rheumatoid arthritis (aHR 1.41 [1.15–1.73]), passive smoking (aHR 1.30 [1.22–1.40]), PM10 (aHR 1.10 [1.09–1.11]), and PM2.5 (aHR 1.16 [1.03–1.30]) pollution were associated with LCINS. In planned subgroup analyses by region, LCINS was associated with family history of lung cancer in East Asian (aHR 1.56 [1.23–1.98]) but not Western countries (aHR 0.86 [0.35–2.11]).
Conclusion
We found key factors linked with LCINS, including female sex, rheumatoid arthritis, and pollution and, for the first time, quantified their association through meta-analyses of studies globally. This may be used to develop tools to detect LCINS earlier.
{"title":"Risk Factors Associated With Incidence of Lung Cancer in Never-Smokers: A Systematic Review and Meta-Analysis","authors":"Sindhu Bhaarrati Naidu M.B.B.S. , Allegra Wisking BSc , Akul Karoshi BSc , Sarah Burdett MSc , Peter J. Godolphin PhD , Sanjay Popat PhD , OLIVE PPI Group, Sam M. Janes PhD , Neal Navani PhD","doi":"10.1016/j.jtocrr.2025.100910","DOIUrl":"10.1016/j.jtocrr.2025.100910","url":null,"abstract":"<div><h3>Objectives</h3><div>Lung cancer is the leading cause of cancer mortality globally. Although often associated with smoking, up to 25% of cases worldwide and 50% in East Asia occur in “never-smokers.” There are currently no robust tools for predicting lung cancer in individuals who have never smoked (LCINS) for populations outside East Asia.</div><div>Together with a group of patient representatives, the authors of this study aimed to summarise risk factors for LCINS and quantify risk in different geographical regions.</div></div><div><h3>Methods</h3><div>This study was prospectively registered (PROSPERO-CRD42022379253). The systematic review and meta-analysis included studies published from 2017 and aimed to comprehensively investigate risk factors associated with LCINS incidence. Risk of bias was assessed using Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>A total of 6725 reports were identified and 54 studies were included, with multivariable analysis of 192 factors in 16 million never-smokers. No studies were assessed as having high risk of bias. Of the participants, 8,241,269 (51.0%) were from Western countries.</div><div>The meta-analysis found that female sex (adjusted hazard ratio [aHR] 1.28 [95% confidence interval or CI 1.12–1.47]), previous cancer (aHR 2.04 [1.95–2.13]), rheumatoid arthritis (aHR 1.41 [1.15–1.73]), passive smoking (aHR 1.30 [1.22–1.40]), PM10 (aHR 1.10 [1.09–1.11]), and PM2.5 (aHR 1.16 [1.03–1.30]) pollution were associated with LCINS. In planned subgroup analyses by region, LCINS was associated with family history of lung cancer in East Asian (aHR 1.56 [1.23–1.98]) but not Western countries (aHR 0.86 [0.35–2.11]).</div></div><div><h3>Conclusion</h3><div>We found key factors linked with LCINS, including female sex, rheumatoid arthritis, and pollution and, for the first time, quantified their association through meta-analyses of studies globally. This may be used to develop tools to detect LCINS earlier.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100910"},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.1016/j.jtocrr.2025.100909
Lorenza Landi MD , Rita Chiari MD , Marcello Tiseo MD, PhD , Giulio Metro MD , Filippo de Marinis MD , Angelo Delmonte MD , Silvia Novello MD , Diego Luigi Cortinovis MD , Domenico Galetta MD , Laura Bonanno MD , Cesare Gridelli MD , Alessandro Morabito MD , Francesco Grossi MD , Andrea Torchia MD , Diana Giannarelli PhD , Gloria Borra MD , Francesca Mazzoni MD , Sara Pilotto MD , Federico Cappuzzo MD
Introduction
Crizotinib, the first approved targeted therapy for ALK-positive advanced NSCLC, is also indicated for ROS1-rearranged NSCLC. This post hoc analysis of the phase II METROS trial explores long-term survival outcomes with crizotinib, focusing on the impact of baseline brain metastases (BM).
Methods
This post hoc analysis of the METROS study assessed survival outcomes in patients with ROS1-rearranged NSCLC, evaluating progression-free survival (PFS), overall survival (OS), and the incidence and severity of adverse events, both in the overall cohort and by baseline BM status.
Results
Among 64 patients with ROS1-positive NSCLC with a median follow-up of 54.4 months, median PFS and OS were 13.8 months (95% CI: 7.4–20.2) and 40.5 months (95% CI: 27.9–53.1), respectively. Patients with BM (N = 17) had significantly shorter PFS (6.8 versus 17.4 mo) and OS (16.4 versus 42.8 mo) than those without BM. The safety profile of crizotinib remained consistent with previous reports, with most adverse events being grade 1 or 2 and no new safety concerns identified.
Conclusion
This analysis supports the efficacy of crizotinib in patients with advanced NSCLC and ROS1 rearrangements, although its activity in patients with BM remains limited, highlighting the need for brain-penetrant tyrosine kinase inhibitors to improve outcomes in this patient group.
{"title":"Crizotinib in Patients With ROS1-Positive NSCLC With or Without Brain Metastases: Post Hoc Analysis of Phase II METROS Trial","authors":"Lorenza Landi MD , Rita Chiari MD , Marcello Tiseo MD, PhD , Giulio Metro MD , Filippo de Marinis MD , Angelo Delmonte MD , Silvia Novello MD , Diego Luigi Cortinovis MD , Domenico Galetta MD , Laura Bonanno MD , Cesare Gridelli MD , Alessandro Morabito MD , Francesco Grossi MD , Andrea Torchia MD , Diana Giannarelli PhD , Gloria Borra MD , Francesca Mazzoni MD , Sara Pilotto MD , Federico Cappuzzo MD","doi":"10.1016/j.jtocrr.2025.100909","DOIUrl":"10.1016/j.jtocrr.2025.100909","url":null,"abstract":"<div><h3>Introduction</h3><div>Crizotinib, the first approved targeted therapy for <em>ALK</em>-positive advanced NSCLC, is also indicated for <em>ROS1</em>-rearranged NSCLC. This post hoc analysis of the phase II METROS trial explores long-term survival outcomes with crizotinib, focusing on the impact of baseline brain metastases (BM).</div></div><div><h3>Methods</h3><div>This post hoc analysis of the METROS study assessed survival outcomes in patients with <em>ROS1</em>-rearranged NSCLC, evaluating progression-free survival (PFS), overall survival (OS), and the incidence and severity of adverse events, both in the overall cohort and by baseline BM status.</div></div><div><h3>Results</h3><div>Among 64 patients with <em>ROS1</em>-positive NSCLC with a median follow-up of 54.4 months, median PFS and OS were 13.8 months (95% CI: 7.4–20.2) and 40.5 months (95% CI: 27.9–53.1), respectively. Patients with BM (N = 17) had significantly shorter PFS (6.8 versus 17.4 mo) and OS (16.4 versus 42.8 mo) than those without BM. The safety profile of crizotinib remained consistent with previous reports, with most adverse events being grade 1 or 2 and no new safety concerns identified.</div></div><div><h3>Conclusion</h3><div>This analysis supports the efficacy of crizotinib in patients with advanced NSCLC and <em>ROS1</em> rearrangements, although its activity in patients with BM remains limited, highlighting the need for brain-penetrant tyrosine kinase inhibitors to improve outcomes in this patient group.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100909"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.1016/j.jtocrr.2025.100905
Jennifer A. Lewis MD, MS, MPH , Lauren R. Samuels PhD , Lucy B. Spalluto MD, MPH , Christopher Lindsell PhD , Claudia I. Henschke PhD, MD , David F. Yankelevitz MD , Carol Callaway-Lane DNP, ACNP-BC , Robert S. Dittus MD, MPH , Hilary A. Tindle MD, MPH , Renda Soylemez Wiener MD, MPH , Christopher G. Slatore MD, MS , Drew Moghanaki MD, MPH , Carolyn M. Audet PhD , Christianne L. Roumie MD, MPH
Introduction
Implementation of lung cancer screening is suboptimal. Understanding health care provider preferences and behavior is important for implementation. In this work, provider preferences for lung cancer screening implementation and self-reported determinants of lung cancer screening behavior were reported using the theoretical domains framework.
Methods
In this mixed-methods evaluation, health care providers at nine Veterans Affairs were surveyed to list factors influencing their decision to screen patients for lung cancer in free-text responses and rank implementation strategies by usefulness in clinical practice. Free-text data were coded and mapped to the theoretical domains framework. Quantitative ranking data were descriptively analyzed overall and by specialty (primary care versus radiology), clinic setting (hospital versus community), and provider type (physician versus advanced practice provider).
Results
Of 234/254 eligible providers analyzed, most were primary care (83.8%), community-based (52.1%), and physicians (66.2%). Respondents identified social influences (69.2%), knowledge (55.6%), and environmental context and resources (15.4%) as influential behavioral determinants. Overall, patient reminders (29.9%), provider reminders (26.1%), and learning collaboratives (24.4%) were reported most frequently as useful implementation strategies. Strategy preferences differed by specialty, practice setting, and provider type: primary care (30.1%), physician (34.2%), and hospital-based (33.0%) providers most frequently ranked patient reminders; radiology providers most frequently ranked learning collaborative (42.1%); advanced practice providers (24.1%) and community-based providers (27.0%) most frequently ranked provider reminders as most useful.
Conclusions
Designing implementation strategies that target three behavioral determinants (social influences, knowledge, and environmental context and resources) and are tailored to providers’ preferences may effectively change providers’ lung cancer screening behavior.
{"title":"Provider Behavioral Determinants and Preferences for Lung Cancer Screening Implementation: A Brief Report","authors":"Jennifer A. Lewis MD, MS, MPH , Lauren R. Samuels PhD , Lucy B. Spalluto MD, MPH , Christopher Lindsell PhD , Claudia I. Henschke PhD, MD , David F. Yankelevitz MD , Carol Callaway-Lane DNP, ACNP-BC , Robert S. Dittus MD, MPH , Hilary A. Tindle MD, MPH , Renda Soylemez Wiener MD, MPH , Christopher G. Slatore MD, MS , Drew Moghanaki MD, MPH , Carolyn M. Audet PhD , Christianne L. Roumie MD, MPH","doi":"10.1016/j.jtocrr.2025.100905","DOIUrl":"10.1016/j.jtocrr.2025.100905","url":null,"abstract":"<div><h3>Introduction</h3><div>Implementation of lung cancer screening is suboptimal. Understanding health care provider preferences and behavior is important for implementation. In this work, provider preferences for lung cancer screening implementation and self-reported determinants of lung cancer screening behavior were reported using the theoretical domains framework.</div></div><div><h3>Methods</h3><div>In this mixed-methods evaluation, health care providers at nine Veterans Affairs were surveyed to list factors influencing their decision to screen patients for lung cancer in free-text responses and rank implementation strategies by usefulness in clinical practice. Free-text data were coded and mapped to the theoretical domains framework. Quantitative ranking data were descriptively analyzed overall and by specialty (primary care versus radiology), clinic setting (hospital versus community), and provider type (physician versus advanced practice provider).</div></div><div><h3>Results</h3><div>Of 234/254 eligible providers analyzed, most were primary care (83.8%), community-based (52.1%), and physicians (66.2%). Respondents identified social influences (69.2%), knowledge (55.6%), and environmental context and resources (15.4%) as influential behavioral determinants. Overall, patient reminders (29.9%), provider reminders (26.1%), and learning collaboratives (24.4%) were reported most frequently as useful implementation strategies. Strategy preferences differed by specialty, practice setting, and provider type: primary care (30.1%), physician (34.2%), and hospital-based (33.0%) providers most frequently ranked patient reminders; radiology providers most frequently ranked learning collaborative (42.1%); advanced practice providers (24.1%) and community-based providers (27.0%) most frequently ranked provider reminders as most useful.</div></div><div><h3>Conclusions</h3><div>Designing implementation strategies that target three behavioral determinants (social influences, knowledge, and environmental context and resources) and are tailored to providers’ preferences may effectively change providers’ lung cancer screening behavior.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100905"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-17DOI: 10.1016/j.jtocrr.2025.100904
Matthew Lu MD , Hayden Byrd MD , Heidi Chen PhD , Wade Iams MD
Introduction
For patients with limited-stage SCLC (LS-SCLC), tumor burden is a predictor of clinical outcomes, but there are no known data exploring whether tumor burden is a predictor of clinical outcomes in relapsed SCLC.
Methods
In this retrospective correlative study analyzing a cohort of 93 patients with relapsed SCLC, total body tumor volume at time of relapse (TV), progression-free survival (PFS), and overall survival (OS) were calculated and a Cox proportional hazards model was used to evaluate the relationship between TV and PFS and OS.
Results
A total of 93 patients with relapsed SCLC were analyzed, of whom 70% initially had extensive-stage SCLC (ES-SCLC) and 30% initially had LS-SCLC. Eastern Cooperative Oncology Group performance status and receipt of second-line therapy were significantly associated with OS in a linear fashion (p = 0.002 and p = 0.0457, respectively). TV was significantly associated with OS in a nonlinear fashion, even when controlling for Eastern Cooperative Oncology Group performance status, response to initial therapy, chemotherapy-free interval, and receipt of second-line therapy (p = 0.0031).
Conclusions
TV was observed to be a predictor of OS in patients with relapsed SCLC. Further studies are needed to evaluate whether initiation of standard systemic therapy at lower TV is able to consistently improve PFS and OS in relapsed SCLC.
{"title":"Brief Report: Relationship Between Tumor Volume and Clinical Outcomes in Relapsed SCLC","authors":"Matthew Lu MD , Hayden Byrd MD , Heidi Chen PhD , Wade Iams MD","doi":"10.1016/j.jtocrr.2025.100904","DOIUrl":"10.1016/j.jtocrr.2025.100904","url":null,"abstract":"<div><h3>Introduction</h3><div>For patients with limited-stage SCLC (LS-SCLC), tumor burden is a predictor of clinical outcomes, but there are no known data exploring whether tumor burden is a predictor of clinical outcomes in relapsed SCLC.</div></div><div><h3>Methods</h3><div>In this retrospective correlative study analyzing a cohort of 93 patients with relapsed SCLC, total body tumor volume at time of relapse (TV), progression-free survival (PFS), and overall survival (OS) were calculated and a Cox proportional hazards model was used to evaluate the relationship between TV and PFS and OS.</div></div><div><h3>Results</h3><div>A total of 93 patients with relapsed SCLC were analyzed, of whom 70% initially had extensive-stage SCLC (ES-SCLC) and 30% initially had LS-SCLC. Eastern Cooperative Oncology Group performance status and receipt of second-line therapy were significantly associated with OS in a linear fashion (<em>p</em> = 0.002 and <em>p</em> = 0.0457, respectively). TV was significantly associated with OS in a nonlinear fashion, even when controlling for Eastern Cooperative Oncology Group performance status, response to initial therapy, chemotherapy-free interval, and receipt of second-line therapy (<em>p</em> = 0.0031).</div></div><div><h3>Conclusions</h3><div>TV was observed to be a predictor of OS in patients with relapsed SCLC. Further studies are needed to evaluate whether initiation of standard systemic therapy at lower TV is able to consistently improve PFS and OS in relapsed SCLC.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100904"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The rationale underlying the benefits of the parenchyma-preserving nature of sublobar resection (SR) compared with lobectomy remains unclear. This study aimed to assess postoperative changes in cardiopulmonary function after lobectomy and SR using exercise stress testing.
Methods
This prospective, observational study enrolled patients scheduled for lobectomy or SR. Changes in cardiopulmonary function at 6 months postoperatively were evaluated using exercise stress echocardiography and cardiopulmonary exercise tests.
Results
Initially, 41 patients were enrolled, with 20 patients in the lobectomy group and 18 patients in the SR group (16 segmentectomies, two wedge resections) after excluding three ineligible patients. Preoperatively, all patients demonstrated well-preserved cardiopulmonary function. The systolic pulmonary artery pressure (SPAP) change at peak exercise was significantly higher for lobectomy (median 26.5%; interquartile range [IQR] 0.6–60.1) than for SR (median −8.2%; IQR −38.7–11.7; p = 0.001), despite nonsignificant differences at rest (p = 0.599). Postoperative exercise-induced pulmonary hypertension (exPH) occurred in nine patients (45%) in the lobectomy group but none in the SR group (0%, p = 0.010). Postoperative peak oxygen consumption during exercise decreased significantly in the lobectomy group (median −14.3%; IQR −24.0 to −4.2) compared with that in the SR group (median −7.8%; IQR −13.5–8.7; p = 0.024). The postoperative increase in SPAP at peak exercise (r = 0.402, p = 0.012), prevalence of postoperative exPH (r = 0.978, p = 0.004), and postoperative decrease in peak oxygen consumption (r = −0.330; p = 0.041) were correlated with the number of resected segments.
Conclusions
Lobectomy induces increased SPAP during exercise, exPH, and effort intolerance, compared with SR. This highlights the importance of preserving lung parenchyma in lung surgery.
Clinical Trial Registration
This trial is registered in the UMIN Clinical Trials Registry under the code UMIN000053694.
与肺叶切除术相比，叶下切除术（SR）保留实质的好处的基本原理尚不清楚。本研究旨在通过运动应激试验评估肺叶切除术和SR术后心肺功能的变化。方法：本前瞻性观察性研究纳入了计划行肺叶切除术或手术后6个月心肺功能变化的患者，采用运动应激超声心动图和心肺运动试验进行评估。结果最初纳入41例患者，其中肺叶切除术组20例，SR组18例（16节段切除术，2例楔形切除术），排除了3例不符合条件的患者。术前，所有患者均表现出良好的心肺功能。肺叶切除术患者在运动高峰时的肺动脉收缩压（SPAP）变化（中位数26.5%；四分位间距[IQR] 0.6-60.1）显著高于SR组（中位数- 8.2%;IQR - 38.7-11.7; p = 0.001），尽管静止时差异不显著（p = 0.599）。肺叶切除术组有9例（45%）患者出现术后运动性肺动脉高压（exPH）， SR组无一例（0%,p = 0.010）。肺叶切除术组术后运动时峰值耗氧量明显低于SR组（中位数为- 7.8%，IQR为- 13.5-8.7,p = 0.024）（中位数为- 14.3%，IQR为- 24.0 - - 4.2）。术后运动峰值SPAP升高（r = 0.402, p = 0.012）、术后exPH发生率（r = 0.978, p = 0.004）、术后峰值耗氧量下降（r = - 0.330, p = 0.041）与切除节段数相关。结论与手术相比，手术切除可导致运动时SPAP、exPH和力耐受增加，这突出了在肺手术中保留肺实质的重要性。临床试验注册本试验在UMIN临床试验注册中心注册，代码为UMIN000053694。
{"title":"Lobectomy Induces Exercise-Induced Pulmonary Hypertension and Effort Intolerance Compared With Sublobar Resection","authors":"Atsushi Kamigaichi MD , Yasuhiro Tsutani MD, PhD , Akane Tsuchiya MD , Hiroto Utsunomiya MD, PhD , Yoshihiro Miyata MD, PhD , Takahiro Mimae MD, PhD , Norifumi Tsubokawa MD, PhD , Yukiko Nakano MD, PhD , Morihito Okada MD, PhD","doi":"10.1016/j.jtocrr.2025.100903","DOIUrl":"10.1016/j.jtocrr.2025.100903","url":null,"abstract":"<div><h3>Introduction</h3><div>The rationale underlying the benefits of the parenchyma-preserving nature of sublobar resection (SR) compared with lobectomy remains unclear. This study aimed to assess postoperative changes in cardiopulmonary function after lobectomy and SR using exercise stress testing.</div></div><div><h3>Methods</h3><div>This prospective, observational study enrolled patients scheduled for lobectomy or SR. Changes in cardiopulmonary function at 6 months postoperatively were evaluated using exercise stress echocardiography and cardiopulmonary exercise tests.</div></div><div><h3>Results</h3><div>Initially, 41 patients were enrolled, with 20 patients in the lobectomy group and 18 patients in the SR group (16 segmentectomies, two wedge resections) after excluding three ineligible patients. Preoperatively, all patients demonstrated well-preserved cardiopulmonary function. The systolic pulmonary artery pressure (SPAP) change at peak exercise was significantly higher for lobectomy (median 26.5%; interquartile range [IQR] 0.6–60.1) than for SR (median −8.2%; IQR −38.7–11.7; <em>p</em> = 0.001), despite nonsignificant differences at rest (<em>p</em> = 0.599). Postoperative exercise-induced pulmonary hypertension (exPH) occurred in nine patients (45%) in the lobectomy group but none in the SR group (0%, <em>p</em> = 0.010). Postoperative peak oxygen consumption during exercise decreased significantly in the lobectomy group (median −14.3%; IQR −24.0 to −4.2) compared with that in the SR group (median −7.8%; IQR −13.5–8.7; <em>p</em> = 0.024). The postoperative increase in SPAP at peak exercise (r = 0.402, <em>p</em> = 0.012), prevalence of postoperative exPH (r = 0.978, <em>p</em> = 0.004), and postoperative decrease in peak oxygen consumption (r = −0.330; <em>p</em> = 0.041) were correlated with the number of resected segments.</div></div><div><h3>Conclusions</h3><div>Lobectomy induces increased SPAP during exercise, exPH, and effort intolerance, compared with SR. This highlights the importance of preserving lung parenchyma in lung surgery.</div></div><div><h3>Clinical Trial Registration</h3><div>This trial is registered in the UMIN Clinical Trials Registry under the code UMIN000053694.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100903"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.jtocrr.2025.100900
Sun Min Lim MD, PhD , Ana Laura Ortega Granados MD , Gustavo dix Junqueira Pinto MD, MSc , Christian Sebastián Fuentes MD , Giuseppe Lo Russo MD , Michael Schenker MD , Jin Seok Ahn MD, PhD , Filippo de Marinis MD , Kenneth Locke Jr. PhD , Zsolt Szijgyarto PhD , Elena Buss MSc , Neda Stjepanovic MD, PhD , Ivan Diaz-Padilla MD, PhD , Solange Peters MD, PhD
Introduction
PERLA is a global, double-blind, phase II trial comparing anti–programmed cell death protein 1 antibodies, dostarlimab, and pembrolizumab in combination with chemotherapy (D+CT and P+CT, respectively) in patients with metastatic nonsquamous NSCLC without actionable genomic aberrations in the first-line setting.
Methods
Patients were randomized 1:1 to receive not more than 35 cycles of 500 mg dostarlimab or 200 mg pembrolizumab, with less than or equal to 35 cycles of 500 mg/m2 pemetrexed and less than or equal to 4 cycles of cisplatin (75 mg/m2) or carboplatin (area under the curve 5 mg/mL/min) every 3 weeks. The primary end point was the overall response rate by blinded independent central review. The secondary end points included progression-free survival (PFS) on the basis of investigator assessment, overall survival (OS), and safety. Here, we reported on the long-term OS, PFS, and safety analyses.
Results
At the end of the study (September 10, 2024), the median follow-up time (mo) for PFS was 30.4 for D+CT and 30.4 for P+CT. The median PFS (mo [95% confidence interval (CI)]) was 8.8 (6.9–11.0) for D+CT and 6.8 (4.9–7.1) for P+CT (hazard ratio 0.77 [95% CI: 0.58–1.03] at 79% maturity). The median follow-up time (mo) for OS was 35.5 for D+CT and 35.2 for P+CT. The median OS (mo [95% CI]) was 20.2 (14.5–27.3) and 15.9 (11.6–19.3), respectively (hazard ratio 0.75 [95% CI: 0.55–1.02] at 70% maturity). Safety profiles were similar between arms and consistent with previous analyses.
Conclusions
This long-term analysis reaffirms previous observations that D+CT exhibited similar efficacy to P+CT and exhibits strong clinical efficacy as a first-line treatment for patients with metastatic nonsquamous NSCLC.
{"title":"Long-term Survival Analysis From PERLA, A Phase II Randomized Trial of Dostarlimab With Chemotherapy Versus Pembrolizumab With Chemotherapy in Metastatic Nonsquamous NSCLC","authors":"Sun Min Lim MD, PhD , Ana Laura Ortega Granados MD , Gustavo dix Junqueira Pinto MD, MSc , Christian Sebastián Fuentes MD , Giuseppe Lo Russo MD , Michael Schenker MD , Jin Seok Ahn MD, PhD , Filippo de Marinis MD , Kenneth Locke Jr. PhD , Zsolt Szijgyarto PhD , Elena Buss MSc , Neda Stjepanovic MD, PhD , Ivan Diaz-Padilla MD, PhD , Solange Peters MD, PhD","doi":"10.1016/j.jtocrr.2025.100900","DOIUrl":"10.1016/j.jtocrr.2025.100900","url":null,"abstract":"<div><h3>Introduction</h3><div>PERLA is a global, double-blind, phase II trial comparing anti–programmed cell death protein 1 antibodies, dostarlimab, and pembrolizumab in combination with chemotherapy (D+CT and P+CT, respectively) in patients with metastatic nonsquamous NSCLC without actionable genomic aberrations in the first-line setting.</div></div><div><h3>Methods</h3><div>Patients were randomized 1:1 to receive not more than 35 cycles of 500 mg dostarlimab or 200 mg pembrolizumab, with less than or equal to 35 cycles of 500 mg/m<sup>2</sup> pemetrexed and less than or equal to 4 cycles of cisplatin (75 mg/m<sup>2</sup>) or carboplatin (area under the curve 5 mg/mL/min) every 3 weeks. The primary end point was the overall response rate by blinded independent central review. The secondary end points included progression-free survival (PFS) on the basis of investigator assessment, overall survival (OS), and safety. Here, we reported on the long-term OS, PFS, and safety analyses.</div></div><div><h3>Results</h3><div>At the end of the study (September 10, 2024), the median follow-up time (mo) for PFS was 30.4 for D+CT and 30.4 for P+CT. The median PFS (mo [95% confidence interval (CI)]) was 8.8 (6.9–11.0) for D+CT and 6.8 (4.9–7.1) for P+CT (hazard ratio 0.77 [95% CI: 0.58–1.03] at 79% maturity). The median follow-up time (mo) for OS was 35.5 for D+CT and 35.2 for P+CT. The median OS (mo [95% CI]) was 20.2 (14.5–27.3) and 15.9 (11.6–19.3), respectively (hazard ratio 0.75 [95% CI: 0.55–1.02] at 70% maturity). Safety profiles were similar between arms and consistent with previous analyses.</div></div><div><h3>Conclusions</h3><div>This long-term analysis reaffirms previous observations that D+CT exhibited similar efficacy to P+CT and exhibits strong clinical efficacy as a first-line treatment for patients with metastatic nonsquamous NSCLC.</div></div><div><h3>Clinical trial registration</h3><div>NCT04581824.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 10","pages":"Article 100900"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.jtocrr.2025.100899
Giorgi Sabakhtarishvili MD, Mitchell B. Karpman PhD, Rahul Mishra MD, Teresa M. Putscher RN, BSN, Omer Bajwa MD, Rachel Hall DO, MS, Sahil Garg MD, Farshid Fargahi MD, Barry Meisenberg MD
Background
Mortality from lung cancer is reduced with low-dose computed tomography (LDCT) screening in high-risk persons. But screening uptake is low, especially among Black persons. Previous reports of LDCT had low participation of Black persons, which may inhibit wider adoption. In this study, we report on outcomes of LDCT screening in Black and White cohorts.
Methods
Retrospective observational cohort study using concurrent data from LDCT screening and tumor registries to compare the results of LDCT efficacy in reducing stage 4 lung cancer presentations in Black and White participant cohorts.
Results
Blacks comprised 13% of the 3647 unique eligible LDCT participants who had at least one LDCT. No statistically significant differences in LDCT category 4 were noted after screening. Lung cancers were diagnosed in 16 out of 466 (3.4%) Black LDCT participants and in 119 out of 3181 (3.7%) White LDCT participants. Black LDCT screening participants were 5.4 times less likely to be diagnosed with stage 4 lung cancers if diagnosed through screening compared to “usual care” (13% versus 44%, p <0.02). White LDCT participants were 3.5 times less likely to present with stage 4 lung cancer if diagnosed through screening compared to usual care (13% versus 35%, p < 0.0001).
Conclusions
LDCT reduced the number of stage 4 presentations in both cohorts. These findings should encourage attempts to increase LDCT utilization in all populations.
{"title":"A Retrospective Observational Cohort Study of Lung Cancer Screening Outcomes Among U.S. Blacks and Whites","authors":"Giorgi Sabakhtarishvili MD, Mitchell B. Karpman PhD, Rahul Mishra MD, Teresa M. Putscher RN, BSN, Omer Bajwa MD, Rachel Hall DO, MS, Sahil Garg MD, Farshid Fargahi MD, Barry Meisenberg MD","doi":"10.1016/j.jtocrr.2025.100899","DOIUrl":"10.1016/j.jtocrr.2025.100899","url":null,"abstract":"<div><h3>Background</h3><div>Mortality from lung cancer is reduced with low-dose computed tomography (LDCT) screening in high-risk persons. But screening uptake is low, especially among Black persons. Previous reports of LDCT had low participation of Black persons, which may inhibit wider adoption. In this study, we report on outcomes of LDCT screening in Black and White cohorts.</div></div><div><h3>Methods</h3><div>Retrospective observational cohort study using concurrent data from LDCT screening and tumor registries to compare the results of LDCT efficacy in reducing stage 4 lung cancer presentations in Black and White participant cohorts.</div></div><div><h3>Results</h3><div>Blacks comprised 13% of the 3647 unique eligible LDCT participants who had at least one LDCT. No statistically significant differences in LDCT category 4 were noted after screening. Lung cancers were diagnosed in 16 out of 466 (3.4%) Black LDCT participants and in 119 out of 3181 (3.7%) White LDCT participants. Black LDCT screening participants were 5.4 times less likely to be diagnosed with stage 4 lung cancers if diagnosed through screening compared to “usual care” (13% versus 44%, <em>p</em> <0.02). White LDCT participants were 3.5 times less likely to present with stage 4 lung cancer if diagnosed through screening compared to usual care (13% versus 35%, <em>p</em> < 0.0001).</div></div><div><h3>Conclusions</h3><div>LDCT reduced the number of stage 4 presentations in both cohorts. These findings should encourage attempts to increase LDCT utilization in all populations.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100899"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-04DOI: 10.1016/j.jtocrr.2025.100898
Jandos Amankulov MD, PhD , David F. Yankelevitz MD , Amangeldi Mukhamejan MD , Rowena Yip PhD, MPH , Emanuela Taioli MD, PhD , Bruce Pyenson FSA, MAAA , James Mulshine MD , Claudia I. Henschke PhD, MD
The First Central Asian Forum on Lung Cancer was held at the National Academy of Sciences of the Republic of Kazakhstan on April 8 and 9, 2025. Organized by the Kazakhstan Cancer Society, KazIOR, and the I-ELCAP/IELCART consortia, the forum brought together regional and international experts to address the urgent challenge of late-stage lung cancer diagnosis in Central Asia. National data show that fewer than one-third of patients are diagnosed at stages I and II, while over 70% present with advanced disease. High smoking prevalence, environmental exposures such as radon, asbestos, and industrial pollution, and strong geographic variation in risk highlight the need for tailored screening programs. Kazakhstan is well-positioned to scale up low-dose CT (LDCT) screening given its CT scanner capacity, mobile units for underserved regions, and prior pilot screening successes. Conference sessions emphasized risk modeling, cost-effectiveness, artificial intelligence applications, and the added value of LDCT for detecting cardiovascular disease and emphysema. Plans are underway for collaborative projects and future conferences to strengthen regional capacity for early detection and treatment.
{"title":"First Central Asian Forum on Lung Cancer","authors":"Jandos Amankulov MD, PhD , David F. Yankelevitz MD , Amangeldi Mukhamejan MD , Rowena Yip PhD, MPH , Emanuela Taioli MD, PhD , Bruce Pyenson FSA, MAAA , James Mulshine MD , Claudia I. Henschke PhD, MD","doi":"10.1016/j.jtocrr.2025.100898","DOIUrl":"10.1016/j.jtocrr.2025.100898","url":null,"abstract":"<div><div>The First Central Asian Forum on Lung Cancer was held at the National Academy of Sciences of the Republic of Kazakhstan on April 8 and 9, 2025. Organized by the Kazakhstan Cancer Society, KazIOR, and the I-ELCAP/IELCART consortia, the forum brought together regional and international experts to address the urgent challenge of late-stage lung cancer diagnosis in Central Asia. National data show that fewer than one-third of patients are diagnosed at stages I and II, while over 70% present with advanced disease. High smoking prevalence, environmental exposures such as radon, asbestos, and industrial pollution, and strong geographic variation in risk highlight the need for tailored screening programs. Kazakhstan is well-positioned to scale up low-dose CT (LDCT) screening given its CT scanner capacity, mobile units for underserved regions, and prior pilot screening successes. Conference sessions emphasized risk modeling, cost-effectiveness, artificial intelligence applications, and the added value of LDCT for detecting cardiovascular disease and emphysema. Plans are underway for collaborative projects and future conferences to strengthen regional capacity for early detection and treatment.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"7 1","pages":"Article 100898"},"PeriodicalIF":3.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Low-dose computed tomography (LDCT) screening for lung cancer has been implemented in many municipalities in Nagano prefecture. We analyzed epidemiologic and survival data of patients with lung cancer among municipalities in Nagano prefecture to evaluate the impact of LDCT.
Methods
This was a retrospective cohort study. Data regarding the number of LDCT screenings, population, and lung cancer deaths in each municipality in 2011 to 2020 were collected and collated with information from the population-based cancer registry. These data were compared between municipalities that had continuously implemented LDCT (LDCT [+], n = 26) and those that had not (LDCT [−], n = 11).
Results
The mean lung cancer crude mortality rate and standardized mortality ratio were significantly lower in LDCT (+) (82.2 ± 14.1 per 100,000 (p < 0.02) and 69.7 ± 11.9 (p < 0.005), respectively) than LDCT (−) (92.0 ± 10.1 per 100,000 and 81.6 ± 11.5, respectively). In addition, the mortality rate in each municipality was significantly negative correlated with the numbers of LDCT implementation in each municipality (r = 0.39). With regard to the extent of lung cancer at diagnosis, the proportion of localized lung cancer was significantly higher in LDCT (+) (39.4 ± 7.4%) than in LDCT (−) (34.6 ± 7.4%), and the proportion of localized lung cancer in each municipality was positively correlated with the number of LDCT implementation.
Conclusion
This retrospective analysis in Nagano prefecture indicated that serial LDCT could contribute to a decrease in lung cancer mortality in the general population.
低剂量计算机断层扫描（LDCT）筛查肺癌已在长野县的许多城市实施。我们分析了长野县各市肺癌患者的流行病学和生存数据，以评估LDCT的影响。方法回顾性队列研究。收集了2011年至2020年每个城市LDCT筛查人数、人口和肺癌死亡人数的数据，并与基于人口的癌症登记处的信息进行了整理。将这些数据在连续实施LDCT的城市（LDCT [+], n = 26）和未实施LDCT的城市（LDCT [-], n = 11）之间进行比较。结果LDCT（+）组肺癌粗死亡率（82.2±14.1 / 10万）和标准化死亡率（69.7±11.9 / 10万）显著低于LDCT（-）组（92.0±10.1 / 10万）和（81.6±11.5）。此外，每个城市的死亡率与每个城市实施LDCT的数量呈显著负相关（r = 0.39）。在肺癌的诊断范围方面，LDCT（+）组肺癌的局限性比例（39.4±7.4%）明显高于LDCT（-）组肺癌的局限性比例（34.6±7.4%），各城市肺癌的局限性比例与LDCT实施次数呈正相关。结论：长野县的回顾性分析表明，连续的LDCT检查有助于降低普通人群的肺癌死亡率。
{"title":"Epidemiologic and Survival Analyses of Lung Cancer in Nagano Prefecture: Impact of Serial Low-Dose Computed Tomography Screening","authors":"Tomonobu Koizumi MD, PhD , Kengo Otsuki , Yuichiro Maruyama MD","doi":"10.1016/j.jtocrr.2025.100893","DOIUrl":"10.1016/j.jtocrr.2025.100893","url":null,"abstract":"<div><h3>Introduction</h3><div>Low-dose computed tomography (LDCT) screening for lung cancer has been implemented in many municipalities in Nagano prefecture. We analyzed epidemiologic and survival data of patients with lung cancer among municipalities in Nagano prefecture to evaluate the impact of LDCT.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study. Data regarding the number of LDCT screenings, population, and lung cancer deaths in each municipality in 2011 to 2020 were collected and collated with information from the population-based cancer registry. These data were compared between municipalities that had continuously implemented LDCT (LDCT [+], n = 26) and those that had not (LDCT [−], n = 11).</div></div><div><h3>Results</h3><div>The mean lung cancer crude mortality rate and standardized mortality ratio were significantly lower in LDCT (+) (82.2 ± 14.1 per 100,000 (<em>p</em> < 0.02) and 69.7 ± 11.9 (<em>p</em> < 0.005), respectively) than LDCT (−) (92.0 ± 10.1 per 100,000 and 81.6 ± 11.5, respectively). In addition, the mortality rate in each municipality was significantly negative correlated with the numbers of LDCT implementation in each municipality (<em>r</em> = 0.39). With regard to the extent of lung cancer at diagnosis, the proportion of localized lung cancer was significantly higher in LDCT (+) (39.4 ± 7.4%) than in LDCT (−) (34.6 ± 7.4%), and the proportion of localized lung cancer in each municipality was positively correlated with the number of LDCT implementation.</div></div><div><h3>Conclusion</h3><div>This retrospective analysis in Nagano prefecture indicated that serial LDCT could contribute to a decrease in lung cancer mortality in the general population.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100893"},"PeriodicalIF":3.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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