5 Ways Sylvester Provides Leading-edge Lung Cancer Surgery
Summary
- Sylvester Comprehensive Cancer Center’s lung cancer surgery program has been designated high performing by U.S. News & World Report for 10 consecutive years and earned a three-star ranking from the Society of Thoracic Surgeons.
- Sylvester’s use of 3D imaging software and robotic-assisted thoracic surgery personalizes surgical planning and preserves healthy lung tissue.
- Sylvester’s Enhanced Recovery after Thoracic Surgery protocol has streamlined postoperative care for all Sylvester thoracic surgery patients.
Teamwork tends to bring about higher levels of success, and ideal surgical outcomes rarely depend solely on surgeons. Success requires the entire patient care team.
At Sylvester Comprehensive Cancer Center, part of UHealth—University of Miami Health System, a strong, engaged team of anesthesiologists, nurses, intensivists, fellows, administrators and many others is at the heart of its renowned lung cancer surgery program.
1. Nationally Recognized Excellence
U.S. News & World Report (USNWR) has rated the Sylvester program “high performing” for 10 consecutive years. The Society of Thoracic Surgeons (STS) has given the program its highest “three-star” ranking in its last two reporting periods. This ranking is among the most sophisticated and highly regarded overall quality measures in health care, evaluating the benchmarked outcomes of cardiothoracic surgery programs in the United States and Canada. This means a patient has a lower probability of complications from lung cancer surgery at Sylvester.
Nestor Villamizar, M.D., associate professor in the DeWitt Daughtry Family Department of Surgery at the University of Miami Miller School of Medicine and program director of the Thoracic Surgery Fellowship Program, said that offering leading lung cancer procedures and garnering national acclaim has contributed to Sylvester’s status as South Florida’s only NCI-designated cancer center. That designation means Sylvester provides greater patient access to clinical trials while attracting investment and experts in the field.
“Achieving the STS three-star rating and the USNWR high-performing status affirms the superior quality of our lung cancer surgery program concerning surgical outcomes of extremely low postoperative complications in Florida,” said Dr. Villamizar. “News of our success may inspire other practitioners around the world to adopt our protocols and surgical techniques to provide better outcomes for their patients.”
2. Minimally Invasive Techniques for Early-stage Lung Cancer
At Sylvester, incorporating a robotic bronchoscopy platform, 3-D reconstruction lung imaging software and a robotic platform for minimally invasive thoracic surgery has revolutionized the detection and treatment of early-stage lung cancers.
Robotic bronchoscopy allows precise biopsies of small or hard-to-detect lung nodules, ensuring accurate diagnosis. This technology can be used during thoracoscopic surgery as a tool to localize small, otherwise undetectable tumors for intraoperative resection and immediate anatomic resection.
“The robotic platform allows us to perform very complex operations with small incisions, including removing the entire lung, connecting bronchus and removing ribs, as well as lung-sparing operations for small cancers,” said Dao Nguyen, M.D., professor in the DeWitt Daughtry Family Department of Surgery, Sylvester Thoracic Cancers Group co-leader and director of minimally invasive/robotic thoracic surgery. “Together with 3D imaging software and robotic-assisted thoracic surgery, we can personalize surgical planning, preserve healthy lung tissue and have real-time imaging for better dexterity.”
3. Lung Cancer Immunotherapy Surgery
At Sylvester, induction chemo-immunotherapy followed by definitive surgical resection for locally advanced lung cancer has become the standard of care. Major pathologic responses (less than 10% of viable cancer remained in the resected tumors) were achieved in 60% of patients treated this way, with up to 40% showing complete eradication of primary cancer and lymph node metastasis.
Such dramatic responses translate to better overall survival, with more patients cured of lung cancer. Sylvester has seen an approximate 90% survival rate in its patient population.
“We were pioneers in implementing induction chemoimmunotherapy while randomized clinical trials were ongoing,” said Dr. Nguyen. “Over 60 patients have benefited from this approach since 2018. We have had no postoperative mortality. Our postoperative complications and length of stay are lower than reported outcomes from other institutions worldwide.”
4. Optimizing Recovery with ERATS
Since its implementation in 2018, the Enhanced Recovery after Thoracic Surgery (ERATS) protocol has significantly streamlined postoperative care for all Sylvester thoracic surgery patients. Up to 65% of patients are discharged after pulmonary resection without opioid prescriptions and remain opioid-free within 90 days post-discharge, explained Dr. Nguyen.
“Our ERATS protocol has resulted in less pain and complications for patients, faster recovery times and shorter hospital stays. Lower costs for insurance and health systems are a bonus,” said Dr. Nguyen.
5. Clinical Research Trials and Innovation
Sylvester’s lung cancer surgeons have built a robust research portfolio. As an academic-based comprehensive cancer center, the institution’s collaborative and academic approach to treatment is unique.
Sylvester’s NCI designation allows its physician-scientists to access the most advanced clinical trials. The cancer center also has the region’s only academic phase 1 clinical trials program. Drs. Nguyen and Villamizar are involved with translational research and have presented at national meetings to encourage collaboration and new areas of investigation for precision medicine, a mainstay that defines Sylvester. Now, the team is evaluating the role of artificial intelligence.
“In addition to even more finely tuned precision surgery, artificial intelligence is where we can look to advance clinical outcome research faster,” said Dr. Villamizar. “It currently takes years to complete clinical trials, and there is a lot of information about therapies applied outside of these trials that is not being studied. If health systems were to collaborate to create large databases using AI, we may be able to predict the most beneficial therapies, individual patient risks, the best candidates for surgery and when to introduce chemotherapy.”
Tags: cancer research, chemoimmunotherapy, Dr. Dao Nguyen, Dr. Nestor Villamizar, immunotherapy, lung cancer, lung cancer surgery