Minimally invasive therapy for lung cancer: we are on the way for international consensus

The Seventh China’s Forum on Minimally Invasive Therapy for Lung Cancer & the Fourth Asia-Pacific Assembly on Video-Assisted Thoracoscopic Surgery (VATS) jointly sponsored by Journal of Thoracic Disease, Annals of Cardiothoracic Surgery and the Ming-Yi Medical Charity Foundation of Guangdong Province, and co-organized by the Professional Committee of Minimally Invasive Endoscopy in the Endoscopic Physician Branch of Chinese Medical Doctor Association (CMDA), State Key Laboratory of Respiratory Diseases/Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University and the www.DXY.CN, was held at the First Affiliated Hospital of Guangzhou Medical University in Guangzhou, known as the flower city and “food palace” in China, during December 14th - 15th, 2013.

Professor Jianxing He, director of the First Affiliated Hospital of Guangzhou Medical University, and Professor Tristan D. Yan, Associate professor of University of Sydney, served as Co-Chairmans of the Forum (Figures 1,2). We welcomed national speakers include Professor Jie He (Figure 3), Professor Xiuyi Zhi (Figure 4), Drs. Xiaojing Zhao and Qun Wang etc. and for international Speakers, we have invited Professors Rene Peterson, Bernard Park, Dominique Gossot, Diego Gonzalez-Rivas, Michael Harden and Christopher Cao.

Figure 1 Jianxing He is the Director and Professor of the Thoracic Surgery Department, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China. He is also the Executive Editor-in-Chief of Journal of Thoracic Disease.

Figure 2 Tristan Yan is the Associate Professor of Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia; The Collaborative Research (CORE) Group, Sydney, Australia. He is also the Editor-in-Chief of Annals of Cardiothoracic Surgery.

Figure 3 Jie He from Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Figure 4 Xiuyi Zhi, from Beijing Lung Cancer Center, Capital Medical University, Beijing, China.

Each year, the Forum on Minimally Invasive Therapy for Lung Cancer held in Guangzhou provides an opportunity for the specialists to discuss ways to improve the results of the surgery. It is also an academic platform for the thoracic surgeons in China and even in Asia-Pacific Area to share and exchange the latest technologies and therapeutic experience on thoracic surgery.

The 2013’s conference was dedicated to three aspects: the Chinese experts’ consensus on VATS, video-assisted thoracoscopic segmentectomy vs. video-assisted thoracoscopic lobectomy for the early NSCLC, and the presentation of complex video-assisted thoracoscopic surgeries (Figure 5).

Figure 5 The Scenario of conference hall during the conference.

Before the opening ceremony, there is a video illustration of the enormous advancement we have achieved in the field of thoracic surgery. Just when the audience became inspired, Prof. He gave a passionate opening speech, pointing out the opportunities we have created and the goal for international experts’ get-together. With high praise for the development of VATS technique in China, Prof. Yan expanded on the VATS Lobectomy 20th Consensus Statement. Prof. Xiuyi Zhi, who came to the conference hall just that morning, announced that the Chinese VATS group of the Chinese Medical Association is established, which laid a foundation of the future development of the VATS technique.

As a simple review in different sections, Prof. Harden introduced his experience regarding how to establish a VATS program, with a focus on addressing how to coordinate all the colleagues during an operation and how to train them to work as a close team (Figure 6). Known to all as a controversial issue, Prof Petersen gave a speech on Segmentectomy vs. Lobectomy demonstrated with excellent surgical video (Figure 7) and Dr. Christopher Cao then share the result of a Meta-analysis on Segmentectomy vs. Lobectomy to provide data proof (Figure 8). Prof. Gossot introduced French approach to segmentectomy (Figure 9) (1). There was little surprise that discussion on VATS to robotic surgery was ignited as Prof. Gossot mentioned his shift of research focus from VATS to robotic surgery, which was regarding a promising field by quite a few surgeons, including Dr. Shumin Wang, one of the national speakers.

Figure 6 Michael Harden from Department of Cardiothoracic Surgery, Royal North Shore Hospital, Australia

Figure 7 Rene Petersen was giving his speech.

Figure 8 Christopher Cao was sharing the result of a Meta-analysis on Segmentectomy vs. Lobectomy.

Figure 9 Dominique Gossot was addressing the topic French approach to segmentectomy.

Following the “Segmentectomy Video demonstrations” section came Prof. Park’s presentation on the Robotic-assisted Pulmonary Resection (Figure 10), as the key lecture in “the Robotic VATS technique” section. Then the application of da Vinci Surgical Robotics in Radical Lobectomy of Lung Carcinoma was introduced by Drs. Xiaojing Zhao (Figure 11) and Shumin Wang respectively. Prof. Gonzalez-Rivas further highlights the technique of Uniportal VATS in his speech (2). None-intubation VATS is one of the highlights for the conference, presented by Prof. He’s surgical team (Figure 12).

Figure 10 Bernard Park was talking on the Robotic-assisted Pulmonary Resection.

Figure 11 Xiaojing Zhao was giving a talk.

Figure 12 Wenlong Shao was presenting his talk.

Each speaker was awarded a commemorative certificate with his close-up after the speech (Figures 13,14). This is a witness of the significant event and a mark for the very moment: we are on the way for international consensus on Minimally Invasive Therapy for Lung Cancer.

Figure 13 Jianxing He presented the certificate to Tristan Yan as an acknowledgement for his excellent presentation.

Figure 14 Jianxing He and Diego Gonzalez-Rivas (left).

Simultaneous translation was available through the whole conference to make sure all the attendees better understand each speech. This conference also designated many sections for discussion between surgeons onsite (Figures 15,16). Some Guest Speakers like Profs. Petersen and Gonzalez-Rivas even spent one or two days around meeting agenda with a view to watching a live operation and having further communication with the surgeons in the hospital.

Figure 15 The attendees are taking a vote on the questions presented in the screen.

Figure 16 The Surgical video demonstration.

As Prof. He put it, this conference was close-knit (highly effective) and presents itself in a new form: video demonstration and the audience get a chance to communicate with the guest speakers in the section of Q&A. “I was so satisfied with the conference as it is and I anticipate conference to be held in more innovative ways and format so that it can become both educational and interesting, and engage more international peers”, said Prof. He.

Successfully, the Seventh China’s Forum on Minimally Invasive Therapy for Lung Cancer & the Fourth Asia-Pacific Assembly on VATS here came to a conclusion to the 2013 conference (Figure 17). Your participation in the upcoming next upcoming VATS conference will be most welcome. For your information, all of the speakers’ latest work will be featured in the upcoming special issues in either Journal of Thoracic Disease (JTD) or Annals of Cardiothoracic Surgery (ACS) soon. They include two special issues on “Surgery for Esophageal Malignancy” (www.jthoracdis.com/announcement/view/63) and “Uniportal VATS and Live Surgery” (www.jthoracdis.com/announcement/view/62) published successively in JTD and the special issue on Sublobar Resection will be published in March in ACS. Please follow up and enjoy.

Figure 17 Picture of all the speakers.

For more detailed information of the present conference (including Presentation PowerPoints and videos), please visit: http://meeting.dxy.cn/specials/jtd2013.

Acknowledgements

Disclosure: The authors declare no conflict of interest.

References

1. Gossot D, Zaimi R, Fournel L, et al. Totally thoracoscopic pulmonary anatomic segmentectomies: technical considerations. J Thorac Dis 2013;5:S200-6. [PubMed]
2. Gonzalez-Rivas D, Mendez L, Delgado M, et al. Uniportal video-assisted thoracoscopic anatomic segmentectomy. J Thorac Dis 2013;5:S226-33. [PubMed]