Background: Artificial intelligence (AI) is rapidly transforming thoracic surgery by enhancing diagnostic accuracy, surgical precision, intraoperative guidance, and postoperative management. AI-driven technologies, including machine learning (ML), deep learning, computer vision, and robotic-assisted surgery, have the potential to optimize clinical workflows and improve patient outcomes. However, challenges such as data integration, ethical concerns, and regulatory barriers must be addressed to ensure AI’s safe and effective implementation. This review aims to analyze the current applications, benefits, limitations, and future directions of AI in thoracic surgery. Methods: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using PubMed, Scopus, Web of Science, and Cochrane Library for studies published up to January 2025. Relevant articles were selected based on predefined inclusion and exclusion criteria, focusing on AI applications in thoracic surgery, including diagnostics, robotic-assisted surgery, intraoperative guidance, and postoperative care. A risk of bias assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I for non-randomized studies. Results: Out of 279 identified studies, 36 met the inclusion criteria for qualitative synthesis, highlighting AI’s growing role in diagnostic accuracy, surgical precision, intraoperative guidance, and postoperative care in thoracic surgery. AI-driven imaging analysis and radiomics have improved pulmonary nodule detection, lung cancer classification, and lymph node metastasis prediction, while robotic-assisted thoracic surgery (RATS) has enhanced surgical accuracy, reduced operative times, and improved recovery rates. Intraoperatively, AI-powered image-guided navigation, augmented reality (AR), and real-time decision-support systems have optimized surgical planning and safety. Postoperatively, AI-driven predictive models and wearable monitoring devices have enabled early complication detection and improved patient follow-up. However, challenges remain, including algorithmic biases, a lack of multicenter validation, high implementation costs, and ethical concerns regarding data security and clinical accountability. Despite these limitations, AI has shown significant potential to enhance surgical outcomes, requiring further research and standardized validation for widespread adoption. Conclusions: AI is poised to revolutionize thoracic surgery by enhancing decision-making, improving patient outcomes, and optimizing surgical workflows. However, widespread adoption requires addressing key limitations through multicenter validation studies, standardized AI frameworks, and ethical AI governance. Future research should focus on digital twin technology, federated learning, and explainable AI (XAI) to improve AI interpretability, reliability, and accessibility. With continued advancements and responsible integration, AI will play a pivotal role in shaping the next generation of precision thoracic surgery.

Immunotherapy with immune checkpoint inhibitors (ICIs) has changed the therapeutic management of advanced non-small cell lung cancer (aNSCLC) over the last decade. However, there is an unmet need for clinically useful biomarkers in this patient subgroup. The aim of this study was to combine baseline clinical characteristics of aNSCLC patients, in the form of a scoring system, and to investigate its predictive and prognostic value in NSCLC patients treated with ICIs. A total of 112 patients with advanced (stages IIIA to IV) NSCLC, treated with nivolumab or pembrolizumab, were enrolled in this study. Patras Immunotherapy Score (PIOS) was developed based on four of the studied parameters (performance status (PS), body mass index (BMI), age, and lines of treatment (LOT), which were incorporated into our formula (PS × BMI/ LOT × age). PIOS score was strongly associated with best overall responses (BOR), with those patients having benefit/good response (stable disease (SD) or partial (PR) or complete response (CR), achieving a higher score compared to patients who developed progressive disease (PD) (p < 0.001). Furthermore, PIOS score was associated with progression-free survival (PFS), since high-score patients had longer PFS (p < 0.001, hazard ratio (HR) = 0.469). Moreover, PIOS was associated with post-immunotherapy overall survival (OS), with high-score patients having improved OS (log-rank p = 0.019). This study suggests that a combination of baseline parameters, which give rise to PIOS score, may predict the best response of NSCLC patients treated with anti-program cell death -1 (PD-1) monotherapy as well as it may have a potent prognostic value for PFS and post immunotherapy OS.

Background: Psychosocial factors such as anxiety, depression, and lack of social support are increasingly recognized as critical determinants of outcomes in cardiac surgery. Up to 32% of patients experience preoperative anxiety, and nearly 20% experience depression, both of which have been associated in observational studies with delayed recovery, increased complications, and higher mortality. Objective: This study aimed to review current evidence on psychosocial aspects of cardiac surgery and evaluate patient-centered care strategies that address these challenges. Methods: A narrative literature review was performed using PubMed, Scopus, and ScienceDirect, focusing on recently published studies. The search covered studies published between January 2009 and June 2024, yielding 76 eligible studies after screening and thematic synthesis. Search terms included patient-centered care, psychosocial factors, cardiac surgery, anxiety, depression, rehabilitation, and telemedicine. Eligible studies included randomized controlled trials, cohort studies, qualitative studies, and systematic reviews. Results: Key themes included preoperative psychological preparation, management of anxiety and depression, promotion of quality of life, effective communication strategies, and integration of psychosocial support into rehabilitation programs. Evidence shows that psychological and social interventions reduce reported pain by up to 33%, as reported in pooled randomized controlled trials and meta-analyses; shorten hospital stay; improve adherence to treatment; and enhance long-term quality of life. Emerging tools such as telemedicine and digital platforms further expand access to psychosocial care. Conclusions: Integrating psychosocial care into cardiac surgery is essential for achieving holistic outcomes. Patient-centered models that emphasize communication, shared decision-making, family involvement, and digital support improve not only survival but also recovery, well-being, and patient satisfaction. Redefining success in cardiac surgery requires attention to both clinical results and the broader human experience of illness and recovery.

Thyroid nodules, prevalent in 2% to 65% of the general population depending on diagnostic methodology, represent a significant clinical concern despite a low malignancy rate, typically 1% to 5%. A substantial proportion of thyroid cancers are small, indolent lesions, allowing for conservative management with favorable prognoses. Nodule detection commonly occurs via palpation, clinical examination, or incidental radiological findings. Established risk factors include advanced age, female gender, obesity, metabolic syndrome, and estrogen dominance. Despite conservative management potential, a considerable number of thyroid nodules in Europe are unnecessarily referred for surgery, incurring unfavorable risk-to-benefit ratios and increased costs. Minimally invasive techniques (MITs), encompassing ethanol and thermal ablation modalities (e.g., laser, radiofrequency, microwave), offer outpatient, nonsurgical management for symptomatic or cosmetically concerning thyroid lesions. These procedures, performed under ultrasound guidance without general anesthesia, are associated with low complication rates. MITs effectively achieve substantial and sustained nodule volume reduction (57–77% at 5 years), correlating with improved local symptoms. Thermal ablation (TA) is particularly favored for solid thyroid lesions due to its precise and predictable tissue destruction. Optimal TA balances near-complete nodule eradication to prevent recurrence with careful preservation of adjacent anatomical structures to minimize complications. Radiofrequency ablation (RFA) is widely adopted, while microwave ablation (MWA) presents a promising alternative addressing RFA limitations. Percutaneous laser ablation (LA), an early image-guided thyroid ablation technique, remains a viable option for benign, hyperfunctioning, and malignant thyroid pathologies. This review comprehensively evaluates RFA, MWA, and LA for thyroid nodule treatment, assessing current evidence regarding their efficacy, safety, comparative outcomes, side effects, and outlining future research directions.

Background/Objectives: Precise staging and tumor delineation are essential for optimizing treatment and enhancing outcomes of radiotherapy (RT). While computed tomography (CT)-based RT remains standard, fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) offers improved detection of primary and nodal disease. This study investigates the role of PET/CT in RT planning of HNSCC. Methods: Fifty-one HNSCC patients underwent radical volumetric modulated arc RT with concurrent cisplatin chemotherapy in a prospective study. Two RT plans per patient were sequentially created by a single oncologist using CT-only and PET/CT data, respectively. Planning target volumes (PTVs) for primary and nodal regions were independently defined, and dose–volume histograms were analyzed and compared. Results: PET/CT significantly affected TNM staging, increasing the T-stage in 11.8% of patients and the N-stage in 33.3%. Distant metastases were found in 9.8% of patients, leading to a redefinition of the overall treatment policy. PET/CT-based planning improved primary tumor PTV coverage (PTV4) in 37.2% (19/51) of cases. The tumor areas excluded from the CT-based planning received an average of 85.6% of the prescribed PTV4 dose (range 18–93%), while in PET/CT planning, they received 95.4% (range 93–99%) (p < 0.0001). Nodal PTV areas requiring a booster dose (PTV2) were adjusted in 33.3% (17/51) of patients during PET-CT planning. These nodal areas received an average of 85.6% of the prescribed dose for PTV2 (range 18–93%) during CT planning, compared to 95.4% (range 93–99%) during PET/CT planning. There was no statistically significant difference in the dose received by organs at risk between CT- and PET/CT-RT planning. Conclusions: PET/CT improves target delineation for primary tumors and lymph nodes, also allowing for dose escalation in metabolically highly active lesions in patients with HNSCC. The method also reveals occult distant metastases in a subset of patients, enabling personalized treatment strategies.

Cardiopulmonary bypass (CPB) is one of the most groundbreaking medical innovations in history, enabling safe and effective heart surgery by temporarily replacing the function of the heart and lungs. This review starts with ancient concepts of cardiopulmonary function and then traces the evolution of CPB through important physiological and anatomical discoveries, culminating in the development of the modern heart–lung machine. In addition to examining the contributions of significant figures like Galen, Ibn al-Nafis, William Harvey, and John Gibbon, we also examine the ethical and technical challenges faced in the early days of open heart surgery. Modern developments are also discussed, such as miniature extracorporeal systems, off-pump surgical techniques, and the increasing importance of extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS), while the evolving role of perfusionists in diverse cardiac teams and the variations in global access to CPB technology are also given special attention. We look at recent advancements in CPB, including customized methods, nanotechnology, artificial intelligence-guided perfusion, and organ-on-chip testing, emphasizing CPB’s enduring significance as a technological milestone and a living example of the cooperation of science, medicine, and human inventiveness because it bridges the gap between the past and the future.