Witold Rzyman1, Kathryn Yan2
1Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland; 2TLCR Editorial Office, AME Publishing Company
Correspondence to: Kathryn Yan. TLCR Editorial Office, AME Publishing Company. Email: editor@tlcr.org.
Editor’s note
Translational Lung Cancer Research (TLCR) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year TLCR launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series “Implementation of CT-based screening of lung cancer” (1) edited by Dr. Witold Rzyman (Figure 1) has attracted many readers since its publication. At this moment, we are honored to have an interview with Dr. Rzyman to share his scientific career experience and insights on this special series.
Figure 1 Witold Rzyman
Expert Introduction:
Dr Rzyman is a certified thoracic and general surgeon with special interests in VATS surgery, tracheal surgery, multimodality treatment of Pancoast tumors and lung cancer screening.
Dr Rzyman is a Chief Surgeon of Thoracic Surgery Department in Medical University of Gdańsk, Poland since 2006, and professor in this institution since 2009. Since 2008 he also lead Department of Thoracic Surgery of Regional Pulmonary Hospital in Prabuty. Employed temporarily between 1995 and 2006 in the Department of Cardiac and Thoracic Surgery of Ulleval University Hospital in Oslo, Norway. Author of 114 publications and 6 book chapters. Scientific interests in miniivasive surgical procedures, tracheal surgery, multimodality treatment of Pancoast tumors, surgical treatment of mesothelioma and thymoma.
Supervisor of lung cancer biocollection of Gdansk Lung Cancer Study Group. In addition to his strictly surgical interests, he is deeply involved in lung cancer screening initiatives as a leader of several grants and projects on lung cancer screening. One of the main organizers of Pilot National LCS Implementation Program in Poland and member of its Scientific committee. Associate Editor of International Lung Cancer News issued by IASLC. He holds positions in many local, national and international committees and organizations.
Interview
TLCR: What drove you into the field of thoracic surgery?
Dr. Rzyman: It was a coincidence. I started working as a general and vascular surgeon. After moving to Gdańsk from Katowice, waiting for a position in the vascular surgery department, I was temporarily employed in the thoracic surgery department ... and I am still there.
TLCR: What do you see as the most significant challenges in implementing lung cancer screening?
Dr. Rzyman: Lung cancer screening is difficult, I would say most challenging of all cancer scrennings. However among the many challenges effective enrollment for screening will play a crucial role.
TLCR: What do you see as the main advantages of lung cancer screening enrollment based on the risk prediction models over standard NCCN selection criteria, and how do you think the application of these risk prediction models has changed the field of lung cancer screening?
Dr. Rzyman: First, it should be emphasized that the NCCN criteria are used in countries that have implemented population-based screening. Risk prediction models are still being explored. However, due to the fact that LCS is evolving rapidly, I expect that the most regionally appropriate risk prediction models will be adopted in many countries in the near future. We need selection criteria that allow for a more accurate definition of the population at risk, but without reducing lung cancer detection compared to the current model.
TLCR: Looking towards the future, what do you believe is the most important direction for the study of diagnosis and treatment of lung cancer? Specifically, what areas of research do you think hold the greatest promise for improving sensitivity in detecting lung cancer?
Dr. Rzyman: Biomarker and radiomic studies in the different levels of diagnosis and treatment pathway are the most promissing areas to explore. For example biomarkers; we need prognostic, diagnostic and predictive biomarker signatures. Actually, they are explored intensively, being in the different level of development, usually in early phases. The main obstacle however in these fields is the lack of appropriate number of biospecimens from the screening cohorts and CT examinations performed in the same standard. We need to collaborate and merge all available recources from different working groups in this field.
In the surgical field we need to concentrate on more efficient methods of nodule identification and on doskonalenie VATS segmentectomies techniques. SBRT and other ablative techiques should be studied as well to treat miniinvasively early lung cancer detected in screening.
The most promising areas for research are biomarker and radiomic studies at different levels of diagnosis and treatment pathways. For example, biomarkers; we need prognostic, diagnostic and predictive biomarker tests. In fact, they are extensively explored, being at various stages of development, usually in the early stages. The main obstacle in these areas, however, is the lack of adequate numbers of biosamples from screening cohorts and CT scans performed to the same standard, this same slice thickness and resolution. We need to collaborate and combine all available resources from the various working groups in this field.
In surgical field, the focus should be on more effective methods of identifying nodules and on improving VATS segmentectomy techniques. SBRT and other ablative techniques should also be explored for the mini-invasive treatment of screening-detected early lung cancer.
TLCR: Have you recently conducted any research projects related to the topic of this series? If so, could you share some of your key findings?
Dr. Rzyman: Our group in Gdańsk has been dealing with the above-mentioned areas since 2009. We have received several grants to discover and validate the molecular and radiomic signatures of early lung cancer. In addition, we focus on comorbidities in lung cancer screening participants and those that are visible on the LDCT image. I think that in the future the LCS will also be an opportunity to check the health status of this target group more widely.
TLCR: If given an opportunity to update this special series, what would you like to moderate, add or emphasize to provide a more comprehensive series?
Dr. Rzyman: Lung cancer screening is a young field that is developing very dynamically, so all the aspects we have touched need to be updated. Definitely, lung cancer screening in non-smokers needs attention, and therefore also the study of the impact of air pollution on carcinogenicity in different regions of the world.
References
- Implementation of CT-based screening of lung cancer. Available online: https://tlcr.amegroups.com/post/view/implementation-of-ct-based-screening-of-lung-cancer