J.Jpn. Surg. Soc.. 125(2): 105-112, 2024

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Feature topic

RANDOMIZED, CONTROLLED TRIALS IN THORACIC SURGERY: THE ROAD TO TOP JOURNALS

In 2022–2023, evidence for minimally invasive surgery for early-stage lung cancer became available. After approximately 30 years, the 2022 edition of the Lung Cancer Treatment Guidelines for the first time addressed a recommendation for minimally invasive resection, categorizing it as “strong recommendation: grade 1.” One piece of evidence supporting this recommendation is the main analysis of JCOG0805/WJOG4607L, published in April 2023 in The Lancet. Since the LCSG821 in 1995, this achievement was built upon the ceaseless efforts of countless predecessors, both domestically and internationally, and across various fields, to establish this novel evidence. In this report, reflecting on the fortunate position of being one of the thoracic surgeons who completed the last piece of this puzzle, I discuss the history of lung cancer surgery, the development strategy of new surgical treatments, and my personal experiences and efforts during the short period in which I submitted papers to two world-renowned journals, the New England Journal of Medicine and The Lancet. Regarding the criteria for publication in top journals, I believe that there are three conditions: 1) high-quality randomized, controlled trials; 2) the world’s first report, and 3) results that overturn standard treatments.

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