Definition of resectable stage III non-small cell lung cancer: a systematic review from EORTC lung cancer group
Xenophontos, E. Giaj Levra, N. Durieux, V. van Geffen, W. H. Grisay, G. De la Pinta Alonso, C. Arasanz, H. Prisciandaro, E. Ferrara, R. Derks, J.
Xenophontos, E.
Giaj Levra, N.
Durieux, V.
van Geffen, W. H.
Grisay, G.
De la Pinta Alonso, C.
Arasanz, H.
Prisciandaro, E.
Ferrara, R.
Derks, J.
Abstract
BACKGROUND: Stage III non-small cell lung cancer (NSCLC) is a heterogenous disease requiring a multimodality treatment approach. For resectable stage III NSCLC, treatments incorporating surgery might be beneficial, however, a definition on resectable disease is lacking. The European Organization for the Treatment and Research of Cancer (EORTC) Lung Cancer Group initiative aims to provide a uniform definition of resectable stage III NSCLC. As part of this initiative, we conducted a systematic review to identify definitions on resectability; the medical specialties involved for making the decision and the required work-up aiding the decision. METHODOLOGY: Studies were included if they provided data or definitions on resectability in stage III NSCLC and were published in English, Dutch, or French between 2005- 2022. RESULTS: Out of 70 eligible articles, 46 provided tumour characteristics determining resectability. Factors against resection included: N3 or bulky N2 disease and locally invasive tumours. Factors favouring resection included N2-single station involvement and cT3N1. It remained unclear whether N2-multiple station and cT4N0-1 without invasion were defined as resectable. A multidisciplinary board including a thoracic surgeon, a medical (pneumo)oncologist and a radiation oncologist were involved in the decision in 95% of studies. PET-CT was considered standard in 70% and brain MRI/CT in 89% of the studies. A pathological mediastinal nodal confirmation was mandatory in 80% of the studies. CONCLUSIONS: This systematic literature review highlights tumour characteristics related to resectability, the specialties responsible for the decision and the most appropriate staging work-up in stage III NSCLC.
Description
Date
2025
Publisher
Collections
Keywords
Type
Article
Citation
Xenophontos E, Giaj Levra N, Durieux V, van Geffen WH, Grisay G, De la Pinta Alonso C, et al. Definition of resectable stage III non-small cell lung cancer: A systematic review from EORTC lung cancer group. Lung cancer (Amsterdam, Netherlands). 2025 Sep;207:108671. PubMed PMID: 40749259. Epub 2025/08/01. eng.