Mariam Khachatryan, Medical Oncology Fellow at Yeolyan Hematology and Oncology Center and Research Analyst at OncoDaily, shared a post on LinkedIn:
“Dr. Olivia Theisen-Lauk delivered an excellent and comprehensive overview at the ESMO – European Society for Medical Oncology Preceptorship on Lung Cancer, highlighting the evolving and complex definition of resectability in stage II–III N2 and selected oligometastatic NSCLC. Her presentation showed how systemic therapy, immunotherapy, and modern surgical practice are reshaping decision-making in thoracic oncology.
- Accurate mediastinal staging is essential.
N2 disease is heterogeneous, imaging can be misleading, and invasive confirmation remains crucial to avoid overstaging.
- Neoadjuvant immunotherapy is transforming practice.
Both tumor and nodal responses are frequent. However, the inflammatory ‘nodal flare’ phenomenon can complicate post-treatment imaging.
- Resectability decisions are dynamic and patient-specific.
Assessing resectability after systemic therapy can reveal new opportunities – whether to proceed with surgery, escalate therapy, or transition to definitive CRT.
- Careful patient selection remains key.
Performance status, controlled primary tumor, nodal burden, and disease-free interval (in metachronous oligometastatic disease) are all important factors.
- Safety and quality of life matter.
LAT or surgery can be effective and safe in experienced centers. Treatment intensity must always be balanced against the patient’s quality of life.
- Biomarker research is ongoing.
Current markers cannot yet reliably predict response, making multidisciplinary evaluation essential.
- Inclusion in clinical trials is important.
Trials support treatment optimization, innovation, and improved outcomes – especially in complex N2 disease.
Take-home message
Choose the timing and approach of LAT to maximize safety and quality of life, minimize treatment duration when possible, and ablate all metastases when indicated. Individualized, multidisciplinary decision-making remains essential.”
More posts featuring Mariam Khachatryan.
