[Comment] Surgical approach matters for long-term lung cancer outcomes

For more than a decade, the medical community has sought to ascertain the oncological effect of perioperative management during cancer surgery.1 Despite encouraging preclinical study results showing that the choice of drugs used during or after surgery and the degree of invasiveness of the surgery could increase the risk of tumour recurrence, no clinical trials have succeeded in translating these results into clinical practice.2,3 This is particularly true for thoracic surgery, a specialty that has witnessed major advances in lung cancer management over recent years with the development of minimally invasive surgical techniques (eg, video-assisted, robotic, uniportal, and monoportal approaches), enhanced post-surgical rehabilitation programmes, and multimodal treatments including neoadjuvant immunotherapy.