Thoracic Surgery

Lung Cancer Control and Epidemiology

Tobacco Control and Primary Prevention
  1. Magnitude of the tobacco epidemic world wide
  2. Global efforts to curb use of tobacco products
  3. Possible impact of these efforts on mortality from lung cancer
Tobacco Cessation
  1. Overview about how lung cancer specialists should help their patients stop tobacco use
  2. Describe mechanisms about how persistent tobacco use affects cancer treatment
  3. Provide information about how to help patients stop tobacco use
Early Detection and Radiologic Screening
  1. Data with regard to modern radiologic techniques in screening for lung cancer
  2. Controversy surrounding those studies
  3. Risks and benefits of screening for lung cancer
  4. Review of radiographic differential diagnosis of pulmonary nodules
  5. Algorithm of the work up of screened nodules by size/ recommended follow-up


Clinical and Radiologic Presentation of Lung Cancer

Clinical Presentation
  1. Symptoms and signs of non small cell lung cancer
  2. Symptoms and signs of small cell lung cancer
  3. Describe paraneoplastic and other syndromes associated with NSCLC
  4. Clinical and molecular methods for the prognostication of lung cancer
PET Imaging of Lung Cancer
  1. Role of FDG in diagnostic algorithm
  2. FDG pet in the prognostication of lung cancer
  3. FDG pet in the determination of response to therapy
  4. Novel tracers: FAZA, FLT


Diagnosis and Staging of Lung Cancer

Diagnostic Work-Up of Suspected Lung Cancer
  1. Outline of the diagnostic work-up of the patient with suspected lung cancer presenting with disease confined to the chest
  2. Role of endoscopic techniques in the diagnosis and staging of lung cancer including broncoscopy, EUS, EBUS, Superdimensions and data on accuracy of staging with these singly or in combination
  3. Role and accuracy of FNA and CORE biopsy in lung cancer
Surgical Staging of the Mediastinum including Mediastinoscopy and Thoracoscopy, Preoperative and Intraoperative
  1. Review the anatomy in the context of the new lymph node map
  2. Discuss the techniques for the invasive staging of the mediastinum
  3. Discuss the prognostic implications of lymph node dissection or sampling
IASLC Staging System
  1. Discuss the present staging system for NSCLC, SCLC carcinoid
  2. Discuss future plans for the staging system


Surgical Management of Lung Cancer

Preoperative Functional Evaluation of the Surgical Candidate
  1. Definition of the marginally resectable patient
  2. Evaluation of preoperative morbidity and mortality of resection
  3. Testing to answer #1 and #2
  4. Comment on preoperative measures to curtail morbidity and mortality including tobacco cessation, pulmonary rehab, etc
  5. Review of modern day periop pain control strategies
Describe modern day open surgical techniques: posterolateral, anterolateral, muscle sparing approaches,sternotomy, clamshell, hemiclamshell
Results of Video Assisted Techniques for Resection of Lung Cancer
  1. Definitions of VATS surgery for lung cancer, specifically pulmonary resections and different varieties of VATS
  2. How does it compare to standard resection both acute and late
  3. What are the benefits and the limitations?
  4. Evidence-based/meta/summary analyses of VATS vs Non-VATS
Results of Robotic Techniques for Resection of Lung Cancer
  1. Definition and description of components of robotic surgery in lung cancer
  2. Contrast robotic lobectomy to other techniques of resection including lymph node resection
  3. Preliminary results to date
Extent of Surgical Resection for Stage I and II Lung Cancer
  1. Role of resection in early-stage lung cancer
  2. What type of resection is performed and what the evidence in the literature is for this
Methodology of clinical trials
  1. Design and endpoint consideratiosn for surgical trials
  2. Results of resection
  3. Role of surgery in IIIA NSCLC
Extended Resections for Lung Cancer: Chest Wall and Pancoast Tumors
  1. Principles guiding the resection of T3 T4 chest wall tumors not in the "classic" Pancoast position
  2. Multidisciplinary management of Pancoast tumors
  3. Results of 1 and 2 and future studies
Extended Resections for Lung Cancer: Broncho/ Vascular Sleeve Resections
  1. How to preoperatively discriminate which patients will require extended resections
  2. The role of sleeve resections of the bronchus and the artery
  3. Technical issues
  4. The long term results by stage
Multiple Nodules: Management of the Patient with Synchronous or Metachronous Lung Cancers
  1. IASLC definitions of these entities
  2. How common and how to determine who is surgical candidate
  3. Specifically discuss management of second primary vs synchronous presentation
  4. What is the role of lung sparing in this situation
  5. Long term results as available
Surgical Management of the Marginally Resectable Patient
  1. What population is this and the magnitude of the problem, discuss combined resection and LVRS effect in selected patients
  2. Role of sublobar resection vs wedge
  3. How to optimize margins in the operating room
  4. Management of the positive margin postoperatively


Radiotherapeutic Management of Lung Cancer

Technical Requirements for Lung Cancer Radiotherapy
  1. Treatment planning, treatment delivery
  2. Talk about stage I patients who are not candidates for SBRT
Radiobiology of Lung Cancer
  1. Radiosensitivity and predictive biomarkers for radiation response
  2. Time dose and fractionation
  3. Modification of radiation response including combined chemoradiation


Other Thoracic Malignancies

Malignant Mesothelioma
  1. Biology of pleural mesothelioma
  2. Biomarkers
  3. Chemotherapy
  4. Surgery
  5. Multimodality
  6. New therapies
Neuroendocrine Tumors of the Lung Other than SCLC
  1. Diagnosis
  2. Surgical management
  3. Chemotherapy and targeted agents
Thymic Cancer/Thymoma
  1. Treatment options according to the stage of the disease
  2. Role of systemic therapy and radiotherapy
  3. Role of MIS platforms (VATS/ transcervical/ robotics)


Symptom Management and Complications

Lung Cancer Emergencies
  1. Massive pleural effusion
  2. Treatment of thoracic pain
  3. Other lung cancer-related emergencies
Role of Palliative Care in Lung Cancer
  1. Describe when palliative care should be used
  2. Describe studies documenting the benefits of palliative care
  3. Discuss the individual components of palliative care
  4. Discuss end of life issues


Clinical Trials

How to Promote and Organize Clinical Research in Lung Cancer
  1. Provide future prospective about how to organize clinical trials
  2. Describe how to promote clinical research in lung cancer