Stage II NSCLC: Staging, Treatment and Survival

Author: Paul Schipper, MD
Institution: OHSU
Date Reviewed: June 2025
Original Case: Stephen C. Yang, MD
Learning Domain: General Thoracic
Learning Objective: Stage II NSCLC: staging, treatment and survival
PowerPoint File: Stage II NSCLC: Staging, Treatment and Survival

 

Learning Goals

  • The basic level concepts focused on:
    • Stage II Staging, Including All Staging Tools
    • Stage II Survival and Recurrence Patterns
  • The advanced level concepts focused on:
    • Stage II Treatment and Multimodality
    • Non-resectional Techniques

 

Discussion Points for Conference

Specific case scenarios/outcomes:

  • PET/CT shows high avidity in RML nodule only, and EBUS yields FNA + NSLCL in RML hilar node
  • PET/CT shows high avidity in RML nodule only; postop path is AdenoCa T1bN1 (2/7 hilar nodes +) with positive bronchial margin
  • PET/CT shows high avidity in RML nodule only; postop path shows AdenoCa in nodule with separate 3mm satellite metastatic nodule

 

Learning Points

  • Staging modalities for intermediate disease:  EBUS, EUS, MRI, mediastinoscopy, VATS
  • Indications for adjuvant therapy, neoadjuvant therapy changing landscape, look it up.
  • Indications for induction therapy, particularly superior sulcus tumors/pancoast tumors.
  • Other definitions for T3N0 (chest wall invasion, satellite nodule in same lobe, atelectasis of entire lung)