Combined Small Cell Lung Cancer (C-SCLC) is a relatively rare type of lung cancer, which involves a combination of small cell carcinoma (SCLC) and any type of non-small cell lung cancer (NSCLC) histological components. The incidence of C-SCLC is increasing, with a higher proportion of affected patients being male and having a history of smoking. Currently, the diagnosis of C-SCLC is mainly based on pathology, and the most common pathological types of the coexisting non-small cell carcinoma components are squamous cell carcinoma and adenocarcinoma. Several studies have identified EGFR, TP53, and RB1 gene mutations, as well as high expression of YAP1, are potential biomarkers of C-SCLC. Treatment options for C-SCLC include surgery, chemotherapy, and radiotherapy in combination. For early-stage C-SCLC, surgical resection is the most effective method, while for patients in the middle or late stages who miss the surgical opportunity, chemotherapy and radiotherapy offer the most benefit. Currently, immunotherapy and targeted therapy show certain potential in the treatment of C-SCLC patients.
ObjectiveTo compare the efficacy of mediastinoscope-assisted transhiatal esophagectomy (MATHE) and functional minimally invasive esophagectomy (FMIE) for esophageal cancer. MethodsPatients who underwent minimally invasive esophagectomy at Jining No.1 Hospital from March 2018 to September 2022 were retrospectively included. The patients were divided into a MATHE group and a FMIE group according to the procedures. The patients were matched via propensity score matching (PSM) with a ratio of 1 : 1 and a caliper value of 0.2. The clinical data of the patients were compared after the matching. ResultsA total of 73 patients were include in the study, including 54 males and 19 females, with an average age of (65.12±7.87) years. There were 37 patients in the MATHE group and 36 patients in the FMIE group. Thirty pairs were successfully matched. Compared with the FMIE group, MATHE group had shorter operation time (P=0.022), lower postoperative 24 h pain score (P=0.031), and less drainage on postoperative 1-3 days (P<0.001). FMIE group had more lymph node dissection (P<0.001), lower incidence of postoperative hoarseness (P=0.038), lower white blood cell and neutrophil counts on postoperative 1 day (P<0.001). There was no statistically significant difference in the bleeding volume, R0 resection, hospital mortality, postoperative hospital stay, anastomotic leak, chylothorax, or pulmonary infection between the two groups (P>0.05). ConclusionCompared with the FMIE, MATHE has shorter operation time, less postoperative pain and drainage, but removes less lymph nodes, which is deficient in oncology. For some special patients such as those with early cancer or extensive pleural adhesions, MATHE may be a suitable surgical method.