Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Programmed cell death protein 1 (PD?1 / CD279) and cytotoxic T Lymphocyte Antigen?4 (CTLA?4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti?CTLA?4/PD?1/PD?L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti?tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer?related deaths worldwide, and its 5?year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo?antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰb clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phaseⅢclinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.

Objective To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS).Methods A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014.Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery.Twenty-one pairs (42 cases) patients were included for analysis.The t-test,x2 test or Fisher's exact probabilities was adopted,if appropriate,to compare demographics and outcomes between the 2 groups.The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons.Results After propensity score-matched analysis,the VATS group had a longer operative time ((296.9±73.6) minutes vs.(218.1±59.2) minutes,t =3.82,P=0.00),but shorter postoperative drainage time ((3.3±1.5) days vs.(2.0±3.0) days,t=-0.93,P=0.01) and hospitalization time((6.7±2.8) days vs.(12.1±8.7)days,t=-1.72,P=0.01) than that of the thoracotomy group.Perioperative complications,1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups.Conclusion For suitable patients,sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.

Objective To evaluate the safety and efficacy of patients with centrally located lung cancer in sleeve lobectomy by video-assisted thoracic surgery (VATS).Methods A retrospective analysis was performed on consecutive patients with centrally located lung cancer who underwent sleeve lobectomy admitted in the Affiliated Hospital of Qingdao University from January 2010 to September 2014.Propensity score matching analysis was performed to compare patients for thoracoscopic surgery and open surgery.Twenty-one pairs (42 cases) patients were included for analysis.The t-test,x2 test or Fisher's exact probabilities was adopted,if appropriate,to compare demographics and outcomes between the 2 groups.The Kaplan-Meier method and the Log-rank test were used for the distributions of disease free survival (DFS) and overall survival (OS) and their comparisons.Results After propensity score-matched analysis,the VATS group had a longer operative time ((296.9±73.6) minutes vs.(218.1±59.2) minutes,t =3.82,P=0.00),but shorter postoperative drainage time ((3.3±1.5) days vs.(2.0±3.0) days,t=-0.93,P=0.01) and hospitalization time((6.7±2.8) days vs.(12.1±8.7)days,t=-1.72,P=0.01) than that of the thoracotomy group.Perioperative complications,1-year and 3-year disease-free and overall survival rates were not statistically different between the two groups.Conclusion For suitable patients,sleeve lobectomy by VATS is an acceptable safe and effective surgical procedure for patients with central lung cancer.

Programmed cell death protein 1 (PD-1/CD279) and cytotoxic T Lymphocyte Antigen-4 (CTLA-4) are important immune checkpoints, through the role of the corresponding ligands and inhibit T cell activation and production of cytokines, in maintaining the body′s vital role in peripheral tolerance. The use of anti-CTLA-4/PD-1/PD-L1 monoclonal antibodies to block the tumor signaling pathway has shown excellent anti-tumor efficacy in a variety of solid tumors, and it is expected that immunotherapy will be available for the treatment of 60% advanced tumors in the next decade. Esophageal cancer is one of the major causes of cancer-related deaths worldwide, and its 5-year survival rate is generally low. Currently, radiotherapy, chemotherapy, and surgery are the standard treatments for esophageal cancer, and there is no effective treatment scheme for patients with esophageal cancer who fail to respond to standard treatment. Due to the diversity of somatic cell gene mutations and the generation of neo-antigens in esophageal cancer, immunotherapy has become a feasible treatment scheme to improve the prognosis of esophageal cancer. In this situation, the application of immunotherapy for esophageal cancer or more specific immune checkpoint inhibitors has gradually become the focus of the treatment of esophageal cancer. Nowadays, the research of immune checkpoint inhibitors, such as ipilimumab, tremelimumab, pembrolizumab, nivolumab and avelumab on esophageal cancer is proceeding at an amazing speed. The phase Ⅰ b clinical study of immunotherapy for esophageal cancer, which previously attracted great interest, has been replaced by the phase Ⅲ clinical study, and the results of the relevant studies also show a good prospect for the application of immune checkpoint inhibitors for esophageal cancer. However, the prediction of therapeutic effect and the selection of the best candidates still need to be further studied.

Objective: To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. Methods: The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using t test, χ² test, Kaplan-Meier curve and Log-rank test, respectively. Results: Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes vs. (171.3±43.5) minutes, t=2.50, P=0.02), more mediastinal lymph node dissection (M(Q_R): 17(9) vs. 11(10), W=388, P=0.02) and shorter postoperative hospital stay (7.0(3.5) vs. 9.0(3.0), W=285, P=0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% vs. 48.1%, P=0.10) and 3-year disease-free survival (67.4% vs. 47.2%, P=0.13) between the two groups. Conclusion Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.