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BTOG 2026 | Evaluating the future of thoracic surgery in treating thoracic malignancies

Aman Coonar, MBBS, MD, MRCP, FRCS, Royal Papworth Hospital, Cambridge, UK, discusses the evolving role of thoracic surgery in managing thoracic malignancies, highlighting the impact of screening on early lung cancer detection and the increasing use of minimally invasive surgery with enhanced recovery pathways. The goal will ultimately be to maximize curative intent resections for small tumors, with a focus on prehabilitation, rehabilitation, and rapid recovery, aiming for same-day or next-day discharge for patients with good performance status. This interview took place at the 2026 British Thoracic Oncology Group (BTOG) congress in Edinburgh, UK.

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Transcript

I was asked to talk about the role of thoracic surgery in the management of thoracic malignancies over the next 10 years. And I think that it’s actually a golden time for the input of thoracic surgery to the multidisciplinary management of patients with lung cancer. So let’s start off with the impact of screening, which is increasing the amount of early lung cancer...

I was asked to talk about the role of thoracic surgery in the management of thoracic malignancies over the next 10 years. And I think that it’s actually a golden time for the input of thoracic surgery to the multidisciplinary management of patients with lung cancer. So let’s start off with the impact of screening, which is increasing the amount of early lung cancer. The role of surgery in that increasingly will be to offer curative intent resection to small tumors. And most of that will be minimally invasive surgery in the context of enhanced recovery. And what is enhanced recovery? Basically a pathway of care almost like a culture of work and care which involves taking the patient from where they are to being far more able to recover faster and that involves prehabilitation and rehabilitation, patient expectation, nutrition, getting things right at home, discharge to virtual hospital. So the aim of thoracic surgery is to maximize the amount of patients who are getting that sort of treatment. And I have every expectation that every patient who comes in who is of good performance status should anticipate going home the next day and some even the same day. And so that is the vision for the majority of lung cancer surgery in 10 years’ time.

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