Although the role of liquid biopsy (LB) to measure minimal residual disease (MRD) in the treatment of epithelial cancer is well known, the biology of the change in the availability of circulating biomarkers arising throughout treatments such as radiotherapy and interventional radio-oncology is less explained. Deep knowledge of how therapeutic effects can influence the biology of the release mechanism at the base of the biomarkers available in the bloodstream is needed for selecting the appropriate treatment-induced tumor circulating biomarker. Combining existing progress in the LB and interventional oncology (IO) fields, a proof of concept is provided, discussing the advantages of the traditional risk assessment of relapsing lesions, limitations, and the timing of detection of the circulating biomarker. The current review aims to help both interventional radiologists and interventional radiation oncologists evaluate the possibility of drawing a tailor-made board of blood-based surveillance markers to reveal subclinical diseases and avoid overtreatment.

Background and Objective: Thymic epithelial tumors (TETs) present peculiar characteristics, with indolent behavior and excellent prognosis when treated. Based on these characteristics, also recurrence may present similar characteristics, but some aspects of their management should be interpreted and are still not well defined. The objective of this narrative review is to discuss peculiar aspects of primary and recurrent TETs showing how should be managed. Methods: A literature search was conducted using PubMed and Google Scholar to inform the narrative review. Eligible articles had to be published in English between January 1, 1991 to September 30, 2025. Key Content and Findings: The presentation of recurrent disease may show some differences compared with primary tumors. Many features are shared by primary TETs and their recurrences, with only limited changes in histology and genetic profiles that do not seem to significantly affect prognosis. Recurrences generally retain the characteristics of the original tumor, although they may exhibit greater clinical aggressiveness. Due to their clinically indolent behavior, these tumors are managed quite peculiarly. Indeed, surgery represents the cornerstone of treatment for these tumors and is often considered, even in cases of recurrence. Conclusions: Primary TETs and recurrences present similar characteristics that may be considered during treatment, even if in case of recurrence the more aggressive behavior should be taken into account.

Background: Spread through air spaces (STAS) is a prognostic factor for survival in non-small cell lung cancer (NSCLC), but the chance to identify it before surgery remains challenging. In this study, we consider clinical, pathological and metabolic factors, with the aim to identify possible STAS predictors in NSCLC. Methods: Clinical and pathological characteristics of patients who underwent anatomical lung resection from 1 January 2018 to 31 December 2023 were retrospectively reviewed and analyzed. Patients with GGO, AIS, or MIA tumors, metastases, or undergoing neoadjuvant therapy were excluded. The parameters assessed by ¹⁸F-FDG PET/CT were: SUVmax, SUVmean, SUVpeak, TLG and MTV. The primary endpoint was the association between clinical, metabolic, and pathologic characteristics with the presence of STAS. A univariate and multivariate logistic regression model was developed to identify independent predictors of STAS. Results: The final analysis was conducted on 224 patients. Non-lepidic-acinar adenocarcinomas showed a statistically significant higher risk of STAS than the lepidic-acinar histotype: 20.8% vs. 4.3%, p = 0.003, OR 5.87, 95%CI 1.83–18.78. Furthermore, tumor grade was significantly associated with STAS: 4.6% in G1–G2 tumors vs. 23.5% in G3 tumors (p = 0.001, OR 5.79, 95%CI 2.12–15.78); as well as lymph vascular invasion (p = 0.034) and tumor size >2 cm (p = 0.017). Multivariate analysis confirmed high tumor grade as an independent risk factor (OR 4.73, 95%CI 1.16–19.23, p = 0.030). Conclusions: In our study, risk of STAS is not correlated with metabolic parameters, while adenocarcinoma subtypes and tumors grading seem to stratify the risk of STAS occurrence. These results may be consolidated in an external validation analysis to possibly better plan the extent of lung resection.

Background: For resectable non-small-cell lung cancer, one of the leading causes of cancer-related mortality, surgical resection remains the best treatment. The increased commonality of minimally invasive approaches is due to their equivalence to open surgery in terms of oncological outcomes and results, despite their offer of the benefits of minimally invasive surgery. Methods: A literature search was conducted using PubMed, Web of Science, Google Scholar and Cochrane Library using the following keywords: VATS, uniportal-VATS, multiportal-VATS, minimally invasive surgery, NSCLC, Segmentectomy, Lobectomy, learning curve, perioperative outcomes, Clinical outcome from 1991 to 30 June 2026. Observational studies, multicenter studies, meta-analysis, systematic reviews and randomized controlled trials were included. Results: Compared to thoracotomy, it has been found that postoperative pain, complication rates and the length of hospital stay can be reduced by minimally invasive approaches without compromising surgical efficacy. The shift towards the single-port techniques further enhances these benefits by minimizing surgical trauma while ensuring the safety and feasibility of the procedure for increasingly complex lung resections. Tailoring is organized along three axes: the extent of resection, patient characteristics and team maturity. Conclusions: Current evidence synthesized in this narrative review suggests that minimally invasive surgery combined with ERAS protocols for anatomical lung resections can further optimize short-term outcomes without compromising the radicality or oncological efficacy of the treatment. The choice of technique is not absolute, but rather the result of a decision based on the individual patient, the surgeon’s experience, and the center’s resources.