Optimizing Pre-operative Clinical Staging in Resectable Non-Small Cell Lung Cancer: A Retrospective Cohort Study

• DOI: 10.25082/ccr.2025.01.002
• Publication Date: 2025-05-13T08:07:21Z
• Authors: Evangeline Samuel; C. Thomas; C. Thompson; E. Paul; M. Cherk; S. Ellis; M. Siemienowicz; S. Tissera; U. Samankula; S. Scholz; L. Zhang; J. Grewal; J. Cox; C. Yu; G. Adabi; D. Keating; J. Taverner; J. Gooi; S. Wayne; John Zalcberg; Rob G. Stirling

Background: Accurate pre-operative clinical staging is vital for guiding treatment decisions in resectable non-small cell lung cancer (NSCLC). Discrepancies between and pathological stages raise concerns about appropriateness. Objective: The objective of the study to determine accuracy stage (cTN) with post-operative (pTN), examine factors predictive inaccurate explore impacts on survival. Patient Methods: This retrospective cohort Melbourne, Australia, analyzed I-IIIA NSCLC patients 2011-2020. Primary exposures were (CT, PET, nodal evaluation) stage. primary outcome was concordance resected NSCLC. Various patient, tumour surgical characteristics quality care metrics collected from medical records. Logistic regression COX proportional hazards assessed influencing Results: Among 221 patients, 58% showed overall concordance. Discordance (42%) frequently led upstaging (23.9%) or downstaging (17.2%) at pathology. Nodal influenced by female sex, SUV max, histology, timing CT surgery. discordance independently correlated higher mortality risk (p = 0.002, HR 2.37). Conclusions: results our indicate inconsistencies methods Further optimization essential receive guideline-concordant treatment. Pathological provides a significant safety can result adverse survival outcomes.