A Mobile Health-Based Management for Patients with Limited Lung Function to Improve Treatment Outcomes and Quality of Life After Minimally Invasive Thoracoscopic Lobectomy.

Objective: Limited lung function is an independent risk factor for postoperative respiratory failure in non-small cell lung cancer (NSCLC) patients. In this study, we developed a mobile health-based management for NSCLC patients with limited lung function who were scheduled to receive lobectomy and evaluated its effects on the patient's pulmonary function and quality of life. Methods: A total of 60 NSCLC patients scheduled to receive minimally invasive thoracoscopic lobectomy were enrolled and then randomized into the traditional management group and the program management group, with 30 patients per group. Based on the WeChat mini program, a management software for patients with limited lung function was established, including two portals: the patient portal and the nurse one. The pain assessment was performed using the Visual Analog Scale (VAS) scores, the cough assessment using the Leicester Cough Questionnaire, and the quality-of-life assessment using the EORTC QLQ-30 at 1 day before surgery, 1 week, 2 weeks, 1 month, 6 months, or 12 months after surgery. Results: The program management group exhibited an increased PaO2 (96.68 ± 7.92 vs. 87.69 vs. 5.50; P = .018) concomitant with a declined PaCO2 (38.55 ± 2.79 vs. 40.65 ± 2.17; p = 0.034) at 12 months after surgery compared with the traditional management group. The VAS scores showed significant differences at 2 weeks after surgery between the traditional management (median: 2; range: 2-3) and program management (median: 2; range: 1-2) groups (P = .012). The scores of Leicester Cough Questionnaire showed remarkable differences at 12 months after surgery between the traditional management (20.00 ± 1.54) and program management (18.99 ± 2.08) groups (P = .036). The total scores of EORTC QLQ-30 showed notable differences at 12 months after surgery between the traditional management (83.05 ± 14.09) and program management (90.55 ± 11.32) groups (P = .027). Conclusion: The study demonstrated improved pulmonary function and a better quality of life conferred by the mobile health-based management based on WeChat mini program for NSCLC patients with limited lung function and undergoing thoracoscopic lobectomy in a long follow up.

Outcomes and quality of life after Robot-assisted lobectomy/segmentectomy for lung cancer compared to video-assisted thoracoscopic surgery: both three-port procedures performed by a single surgeon.

Background: At present, research comparing robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) in lobectomy/segmentectomy for lung cancer is insufficient. This paper aimed to compare the safety, short-term efficacy, quality of life (QoL), and delayed complications at 6 weeks postoperatively via a retrospectively controlled study by a single surgeon. Methods: A total of 110 non-small cell lung cancer (NSCLC) cases from December 2020 to May 2021 were enrolled in this retrospective study, and were divided into RATS and VATS groups (both three-port procedures) according to the patients' preference. The propensity-score matching method was applied to control the potential differences. The patients were treated with lobectomy/segmentectomy for lung cancer by RATS or VATS, and the safety outcomes were evaluated. The follow-up was initiated after surgery, and the outcome assessments including hospitalization costs, short-term efficacy, pain and QoL, were collected and analyzed. Results: Both matched groups achieved a R0 resection rate of 100%. The average operation time of the RATS group was 21 minutes shorter than VATS (P<0.01), and the average hospitalization costs of the RATS group was 17,746 China Yuan higher than VATS (P<0.01). Furthermore, the visual analogue pain scores of the RATS group were lower than those of the VATS group at 1 day and 6 weeks postoperatively (2.53±0.86 vs. 3.88±0.88 and 0.35±0.65 vs. 0.74±0.88, respectively, P<0.05). Moreover, the core QoL scale score for cancer patients in the RATS group were higher than those of the VATS group at 6 weeks postoperatively (98.64±5.73 vs. 93.02±15.21, respectively, P<0.05). No significant differences were observed in the other indicators. Conclusions: Despite its high cost, RATS showed considerable potential for reducing the operation time and improving the QoL of patients. Meanwhile, RATS and VATS exhibited similar perioperative safety and short-term efficacy in lobectomy and segmentectomy.

The circRNA circPTPRA suppresses epithelial-mesenchymal transitioning and metastasis of NSCLC cells by sponging miR-96-5p.

BACKGROUND: Non-small cell lung carcinomas (NSCLC) are prevalent, lethal cancers with especially grim prospects due to late-stage detection and chemoresistance. Circular RNAs (circRNAs) are non-coding RNAs that participate in tumor development. However, the role of circRNAs in NSCLC is not well known. This study investigated the role of one circRNA - circPTPRA- in NSCLC and characterized its molecular mechanism of action. METHODS: circPTPRA expression was analyzed in human NSCLC tumors and matched healthy lung tissue. We performed functional characterization in NSCLC cell lines and a mouse xenograft model of NSCLC to elucidate the molecular role of circPTPRA in epithelial-mesenchymal transitioning (EMT). We also assessed the regulatory action of circPTPRA on the microRNA miR-96-5p and its target the tumor suppressor Ras association domain-containing protein 8 (RASSF8). FINDINGS: circPTPRA was significantly downregulated in NSCLC tumors relative to matched healthy lung tissue. Lower circPTPRA levels correlated with metastasis and inferior survival outcomes in NSCLC patients. circPTPRA suppressed EMT in NSCLC cell lines and reduced metastasis in the murine xenograft model by sequestering miR-96-5p and upregulating RASSF8. Correlation analyses in patient-derived NSCLC tumor specimens supported the involvement of the circPTPRA/miR-96-5p/RASSF8/E-cadherin axis dysregulation in NSCLC tumor progression. INTERPRETATION: circPTPRA suppresses EMT and metastasis of NSCLC cell lines by sponging miR-96-5p, which upregulates the downstream tumor suppressor RASSF8. The circPTPRA/miR-96-5p/RASSF8/E-cadherin axis can be leveraged as a potential treatment avenue in NSCLC. FUND: The Key research and development projects of Anhui Province (201904a0720079), the Natural Science Foundation of Anhui Province (1908085MH240), the Graduate Innovation Program of Bengbu Medical College (Byycx1843), the National Natural Science Foundation of Tibet (XZ2017ZR-ZY033) and the Science and Technology Project of Shannan (SNKJYFJF2017-3) and Academic Subsidy Project for Top Talents in Universities of Anhui in 2019 (gxbjZD16).