Background/Objectives: The aim of this study was to analyze whether the implementation of artificial intelligence (AI), specifically the Natural Language Processing (NLP) branch developed by OpenAI, could help a thoracic multidisciplinary tumor board (MTB) make decisions if provided with all of the patient data presented to the committee and supported by accepted clinical practice guidelines. Methods: This is a retrospective comparative study. The inclusion criteria were defined as all patients who presented at the thoracic MTB with a suspicious or first diagnosis of non-small-cell lung cancer between January 2023 and June 2023. Intervention: GPT 3.5 turbo chat was used, providing the clinical case summary presented in committee proceedings and the latest SEPAR lung cancer treatment guidelines. The application was asked to issue one of the following recommendations: follow-up, surgery, chemotherapy, radiotherapy, or chemoradiotherapy. Statistical analysis: A concordance analysis was performed by measuring the Kappa coefficient to evaluate the consistency between the results of the AI and the committee’s decision. Results: Fifty-two patients were included in the study. The AI had an overall concordance of 76%, with a Kappa index of 0.59 and a consistency and replicability of 92.3% for the patients in whom it recommended surgery (after repeating the cases four times). Conclusions: AI is an interesting tool which could help in decision making in MTBs.
Background/Objectives: The objective was to compare the results of segmentectomy and lobectomy in the treatment of c-stage IA lung cancer in terms of tumor recurrence and 5-year survival. Methods: An observational study was performed using 3533 patients included in the registry of the Spanish VATS Group (GEVATS) of the Spanish Society of Thoracic Surgery (SECT) between 2016 and 2018. A total of 1004 lobectomies and 83 segmentectomies in c-stage IA were selected. Two comparable groups were selected through 2:1 propensity score matching with patient-, tumor- and surgery-related variables, leaving 166 lobectomies and 83 segmentectomies. Tumor recurrence was analyzed by Fisher’s test and overall, cancer-specific, recurrence-free and disease-free survival by Kaplan-Meier and Log-rank tests. Results: Overall recurrence was 23.7% in both groups, with a predominance of locoregional recurrence in segmentectomy (16.2% vs. 11.2%) and distant recurrence in lobectomy (12.5% vs. 7.5%). There was no difference between the two groups in any of the survival types. Overall survival at 5 years was 73.5% (95% CI: 65.5–82.4%) in the lobectomy group vs. 73.1% (95% CI: 60.1–88.9%) in the segmentectomy group. Conclusions: Anatomic segmentectomy may be a valid option in the treatment of c-stage IA lung cancer since the recurrence and long-term survival outcomes compared to lobectomy are equivalent.
Background: Surgical resection remains the standard treatment for early-stage non-small-cell lung cancer (NSCLC). Traditionally, lobectomy has been considered the procedure of choice; however, emerging evidence suggests that trisegmentectomy may offer comparable outcomes. This meta-analysis evaluates whether left upper lobe trisegmentectomy provides non-inferior or superior oncologic outcomes compared to left upper lobectomy, with particular attention to recurrence patterns. Methods: Following PRISMA guidelines, we included comparative studies evaluating left upper lobectomy versus trisegmentectomy. Outcomes assessed included recurrence (locoregional and distant), morbidity, and the length of hospital stay. A meta-analysis was conducted using the metabin function from the R meta package. Results: Of 14 identified articles, 9 met the inclusion criteria. No significant differences were observed in locoregional recurrence. However, distant recurrence was significantly lower in the trisegmentectomy group (OR 0.58; 95% CI 0.41–0.82). While overall morbidity showed no significant difference (OR 0.95), analysis of matched studies favored trisegmentectomy (OR 0.73; 95% CI 0.56–0.96). Hospital stay was significantly shorter in the trisegmentectomy group (OR –0.94; 95% CI –1.26 to –0.63). Conclusions: Trisegmentectomy and lobectomy exhibit distinct recurrence patterns, with lobectomy associated with a higher rate of distant recurrence. Trisegmentectomy may provide oncologic and perioperative advantages in appropriately selected patients. The systematic review and meta-analysis are registered in PROSPERO (registration number: CRD420251066445).