2023 World Conference on Lung Cancer (Posters)-P1.28. Definition of Resectable Stage III Non-small Cell Lung Cancer (NSCLC): A Clinical Case Review by a Pan-European Expert Panel

P1.28. Definition of Resectable Stage III Non-small Cell Lung Cancer (NSCLC): A Clinical Case Review by a Pan-European Expert Panel - PDF(Abstract)

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A clinical case review was conducted by a pan-European expert panel to define resectable stage III non-small cell lung cancer (NSCLC). The study aimed to establish a consensus definition of resectability based on the tumor location, size, relation with thoracic structures, and lymph-node involvement. A consecutive series of stage III-NSCLC patients diagnosed at Institut Jules Bordet from 2016-2021 were included in the study. Chest-CT/PET-CT images and other relevant information were analyzed by multidisciplinary panels consisting of thoracic surgeons, radiation oncologists, medical oncologists/pulmonologists, and imaging specialists. The panels evaluated the cases and determined if the tumors were resectable or not, providing reasons for unresectability if applicable. consensus was reached if there was an agreement of 75% among the panel members.<br /><br />Overall, 105 cases were reviewed, with 50% categorized as stage-IIIA, 39% as stage-IIIB, and 10% as stage-IIIC. After multiple rounds of review, consensus was reached for most T-N categories, except for the T4-invading/N0 category. T3-T4 tumors due to size and satellite nodules, as well as N1-N2 single-station involvement, were considered resectable. T4-invading tumors were mostly deemed unresectable, especially if combined with N2-N3 disease. Tumors invading the esophagus or spinal cord were unanimously defined as unresectable, while some cases involving the heart and vertebra were considered resectable with evaluation in specialized centers. N2-multi-station/bulky or N3 involvement were generally seen as unresectable, although additional investigations were requested in some cases.<br /><br />In conclusion, this study provides a consensus definition of resectability for stage III NSCLC based on a comprehensive review of real-world cases. Further discussion is recommended for subgroups with limited evaluated cases, such as T4-invading/N1-N2 single station.

Asset Subtitle

Mariana Brandao

Meta Tag

Speaker Mariana Brandao

Topic Local-Regional NSCLC

Keywords

clinical case review

resectable stage III NSCLC

consensus definition

tumor location

size

lymph-node involvement

multidisciplinary panels

chest-CT/PET-CT images

unresectability reasons

real-world cases