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The Society of Thoracic Surgeons Expert Consensus on the Multidisciplinary Management and Resectability of Locally Advanced Non-small Cell Lung Cancer

Thursday, December 5, 2024

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Source

Source Name: The Annals of Thoracic Surgery

Author(s)

Samuel S. Kim, David T. Cooke, Biniam Kidane, Luis F. Tapias, John F. Lazar, Jeremiah W. Awori Hayanga, Jyoti D. Patel, Joel W. Neal, Mohamed E. Abazeed, Henning Willers, Joseph B. Shrager

This article provides a consensus-based approach for determining the resectability and optimal management strategies for locally advanced non-small cell lung cancer (NSCLC). The expert panel recommends evaluating resectability through multidisciplinary tumor board (MDT) discussions, with a focus on up-front decisions based on patient operability and tumor biology. It supports neoadjuvant chemoimmunotherapy over adjuvant options for most operable patients without driver mutations, highlighting the increased survival benefits. The guidelines also advise caution with post-induction surgery in patients with extensive or bulky N2 disease, favoring non-surgical treatments unless a multidisciplinary review deems surgery feasible. 
 
This consensus provides evidence-based strategies that integrate modern immunotherapies with surgical options to improve patient outcomes in NSCLC treatment. 

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