山东省VATS/RATS非小细胞肺癌围术期质量控制指标专家共识(2025版)

doi:10.6040/j.issn.1671-7554.0.2025.0494

摘要/Abstract

摘要： 肺癌是发病率和死亡率最高的恶性肿瘤,手术切除仍是早期肺癌治疗的最有效方法。然而,山东省各医疗机构的肺癌围术期管理水平存在差异,亟需提高肺癌诊疗的规范化、同质化水平。在“健康中国2030”规划背景下,相关政策对癌症诊疗质量控制提出了更高要求。基于此,山东省腔镜外科质量控制中心胸腔镜委员会根据最新证据和指南共识,结合山东诊疗特色,参考国家卫生健康委员会和国家考核质量控制指标,制定了山东省电视辅助胸腔镜手术(video-assisted thoracic surgery, VATS)/ 机器人辅助胸腔镜手术(robot-assisted thoracic surgery, RATS)非小细胞肺癌围术期质量控制指标专家共识,旨在推动山东省非小细胞肺癌围术期管理规范化,改善非小细胞肺癌患者预后,助力实现“健康中国2030”目标。

关键词: 山东省, 非小细胞肺癌, 围术期, 质量控制, 专家共识, 电视辅助胸腔镜手术, 机器人辅助胸腔镜手术

Abstract: Lung cancer is the malignancy with the highest incidence and mortality rates, and surgical resection remains the most effective treatment for early-stage lung cancer. However, there are differences in the level of perioperative management of lung cancer among medical centers in Shandong Province, highlighting an urgent need to improve the standardization and homogenization of lung cancer diagnosis and treatment. Under the framework of the "Healthy China 2030" initiative, relevant policies have imposed higher requirements for the quality control of cancer diagnosis and treatment. Based on this, the Thoracoscopic Committee of the Shandong Provincial Endoscopic Surgery Quality Control Center has formulated the Shandong Provincial expert consensus on control indexes of video-assisted thoracic surgery(VATS)/ robot-assisted thoracic surgery(RATS)perioperative quality for non-small cell lung cancer based on the latest evidence and guidelines, aligning with characteristics of Shandong Province, and referencing quality control indicators from the National Health Commission and national examination. This consensus aims to promote standardization of perioperative management of lung cancer in Shandong Province, improve patients outcomes, and contribute to achieving the goals of "Healthy China 2030."

Key words: Shandong Province, Non-small cell lung cancer, Perioperation period, Quality control, Expert consensus, Video-assisted thoracic surgery, Robot-assisted thoracic surgery

中图分类号:

R734.1

山东省腔镜外科质量控制中心胸腔镜委员会. 山东省VATS/RATS非小细胞肺癌围术期质量控制指标专家共识(2025版)[J]. 山东大学学报 (医学版), 2025, 63(12): 1-5.

Thoracoscopic Committee of Shandong Provincial Endoscopic Surgery Quality Control Center. Shandong Provincial expert consensus on control indexes of VATS/RATS perioperative quality for non-small cell lung cancer[J]. Journal of Shandong University (Health Sciences), 2025, 63(12): 1-5.

参考文献

[1] Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263.
[2] Han B, Zheng R, Zeng H, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47-53.
[3] Lin Z, Cheng X. The future and challenges of robotics in lung cancer surgery[J]. Tumor, 2024, 44(6): 631-641.
[4] Casiraghi M, Cara A, Mazzella A, et al. 1000 Robotic-assisted lobectomies for primary lung cancer: 16 years single center experience[J]. Lung Cancer, 2024, 195: 107903. doi: 10.1016/j.lungcan.2024.107903
[5] 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)非小细胞肺癌诊疗指南 2025[M]. 北京: 人民卫生出版社, 2025.
[6] NCCN Clinical Practice Guidelines in Oncology. Non-small cell lung cancer. Version 3.2025[EB/OL].(2025-01-14)[2025-04-27]. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450.
[7] Darling GE, Allen MS, Decker PA, et al. Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1(less than hilar)non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial[J]. J Thorac Cardiovasc Surg, 2011, 141(3): 662-670.
[8] Woo W, Shin JI, Kipkorir V, et al. Clinical benefits of lobe-specific lymph node dissection in surgery for NSCLC: a systematic review and Meta-analysis[J]. JTO Clin Res Rep, 2023, 4(5): 100516. doi: 10.1016/j.jtocrr.2023.100516.
[9] 孙振国, 岳韦名, 高存, 等. 胸腔镜肺癌手术的质量控制[J]. 中华腔镜外科杂志(电子版), 2020, 13(6): 332-336.
[10] Forde PM, Spicer J, Lu S, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer[J]. N Engl J Med, 2022, 386(21): 1973-1985.
[11] Wakelee H, Liberman M, Kato T, et al. Perioperative pembrolizumab for early-stage non-small-cell lung cancer[J]. N Engl J Med, 2023, 389(6): 491-503.
[12] Spicer JD, Garassino MC, Wakelee H, et al. Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone in patients with early-stage non-small-cell lung cancer(KEYNOTE-671): a randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet, 2024, 404(10459): 1240-1252.
[13] Lu S, Zhang W, Wu L, et al. Perioperative toripalimab plus chemotherapy for patients with resectable non-Small cell lung cancer: the neotorch randomized clinical trial[J]. JAMA, 2024, 331(3): 201-211.
[14] Yue D, Wang W, Liu H, et al. Perioperative tislelizumab plus neoadjuvant chemotherapy for patients with resectable non-small-cell lung cancer(RATIONALE-315): an interim analysis of a randomised clinical trial[J]. Lancet Respir Med, 2025, 13(2): 119-129.
[15] Wakelee HA, Altorki NK, Zhou C, et al. IMpower010: final disease-free survival(DFS)and second overall survival(OS)interim results after ≥5 years of follow up of a phase III study of adjuvant atezolizumab vs best supportive care in resected stage IB-IIIA non-small cell lung cancer(NSCLC)[J]. Journal of Clinical Oncology, 2024, 42(17_suppl): LBA8035-LBA8035.
[16] Wu YL, Dziadziuszko R, Ahn JS, et al. Alectinib in resected ALK-positive non-small-cell lung cancer[J]. N Engl J Med, 2024, 390(14): 1265-1276.
[17] Wu YL, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer[J]. N Engl J Med, 2020, 383(18): 1711-1723.
[18] Herbst RS, Wu YL, John T, et al. Adjuvant osimertinib for resected EGFR-mutated stage IB-IIIA non-small-cell lung cancer: updated results from the phase III randomized ADAURA trial[J]. J Clin Oncol, 2023, 41(10): 1830-1840.
[19] Hung HY, Tseng YH, Chao HS, et al. Multidisciplinary team discussion results in survival benefit for patients with stage III non-small-cell lung cancer[J]. PLoS One, 2020, 15(10): e0236503. doi:10.1371/journal.pone.0236503
[20] Shewale JB, Correa AM, Brown EL, et al. Time trends of perioperative outcomes in early stage non-small cell lung cancer resection oatients[J]. Ann Thorac Surg, 2020, 109(2): 404-411.
[21] Andalib A, Ramana-Kumar AV, Bartlett G, et al. Influence of postoperative infectious complications on long-term survival of lung cancer patients: a population-based cohort study[J]. J Thorac Oncol, 2013, 8(5): 554-561.
[22] Deslauriers J, Ginsberg RJ, Piantadosi S, et al. Prospective assessment of 30-day operative morbidity for surgical resections in lung cancer[J]. Chest, 1994, 106(6 Suppl): 329s-330s.
[23] Yamamichi T, Ichinose J, Omura K, et al. Impact of postoperative complications on the long-term outcome in lung cancer surgery[J]. Surg Today, 2022, 52(9): 1254-1261.

相关文章 15

[1]	逄锦宏,苏萍,乔俊鹏,陈巧巧,陈学禹,赵颖颖,施婕,孙晓茹,李秋春,何蕊言,范轶欧,迟蔚蔚. 老年人群可改变心血管危险因素聚集模式与脑卒中的关联[J]. 山东大学学报 (医学版), 2025, 63(9): 11-19.
[2]	赵汉卿,周新睿,李子建,唐兴. 循环肿瘤细胞联合血清学检测在非小细胞肺癌中的应用[J]. 山东大学学报 (医学版), 2025, 63(5): 79-85.
[3]	徐年兴,魏东,乔俊杰,战炳炎. CD8⁺、IL-6和PaO₂对不可切除Ⅲ_B/C和Ⅳ期非小细胞肺癌免疫治疗触发放射召回性肺炎的预测价值[J]. 山东大学学报 (医学版), 2025, 63(2): 29-35.
[4]	刘振昆,吕纪玲,徐伟伟,马力天,张才擎. BALF tNGS检测及培养对NSCLC合并IPFD的诊断价值[J]. 山东大学学报 (医学版), 2025, 63(11): 36-45.
[5]	山东省医学会乳腺疾病多学科联合委员会. 乳腺癌多学科协作诊疗山东共识(2024年版)[J]. 山东大学学报 (医学版), 2025, 63(1): 10-16.
[6]	张荣雨,赵文,李洪欣,杨闯,王健,韩春燕,李际盛. 奥西替尼联合化疗一线治疗EGFR-RAD51融合突变转移性肺腺癌1例[J]. 山东大学学报 (医学版), 2024, 62(5): 116-120.
[7]	华裔骨科学会骨科康复专业委员会. 全膝关节置换术后膝关节功能加速康复专家共识[J]. 山东大学学报 (医学版), 2024, 62(10): 48-61.
[8]	张杨,李晓旭. 加速康复外科理念在骨折治疗中的研究进展[J]. 山东大学学报 (医学版), 2024, 62(10): 18-25.
[9]	执笔专家: 班艳丽, 赵颖, 李桦, 刘薇, 荣风年, 赵淑萍, 崔保霞. 剖宫产子宫瘢痕妊娠实用临床分型诊治专家共识[J]. 山东大学学报 (医学版), 2023, 61(11): 1-10.
[10]	王炯炯,王国永,朱晓艳,李玲,张娜,刘云霞. 山东省1 926例经同性传播HIV感染者治疗及时性分析[J]. 山东大学学报 (医学版), 2023, 61(1): 100-105.
[11]	秦静,杨飞,陈谦,夏涵岱,刘延国,王秀问. 晚期驱动基因阴性、PD-L1表达阴性非鳞非小细胞肺癌一线治疗方案的网状Meta分析[J]. 山东大学学报 (医学版), 2022, 60(7): 74-82.
[12]	陈兆波,方敏,薛浩然,刘春艳. 去泛素化酶USP35促进非小细胞肺癌细胞迁移和侵袭[J]. 山东大学学报 (医学版), 2022, 60(4): 30-37.
[13]	孙薏丰,李伟,孙士营,顾安曼,谭胜楠,傅勋业,王海志,纪建粉,关于旺,吴向前,贺志成,温招阳,于尚嘉,李世易,刘兴红,陈英,王婷婷,孙允东. 2016—2021年山东省11个地区摩根摩根菌的抗生素耐药变迁[J]. 山东大学学报 (医学版), 2022, 60(12): 88-93.
[14]	马瑞杰,朱良明,左太阳,李春海,张楠,孙志钢. 微波消融治疗非小细胞肺癌根治术后肺寡转移瘤的预后分析[J]. 山东大学学报 (医学版), 2022, 60(12): 63-68.
[15]	刘会宁,彭军,任迎春,杨光,王文豪,刘金锋,田勍. 34例胸腔镜下肺楔形切除与21例肺段切除对位于肺段P区的ⅠA1期非小细胞肺癌治疗比较[J]. 山东大学学报 (医学版), 2022, 60(11): 38-43.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed