Induction therapy in non-small-cell lung cancer: a comparison of clinical and post-surgical staging

In the last decade, several neoadjuvant trials for NSCLC patients with mediastinal lymph node involvement (N2) have been scheduled. The uniform plan is based on clinical staging, therapy, clinical re-staging, surgery (when is possible) and, finally, pathological staging. The precise classification of tumor during the three different staging procedures is mandatory. Considering clinical re-staging and pathological staging, nowadays surgery could be considered correct for most of the patients enrolled in the neoadjuvant protocols including cases where a major clinical response has not been achieved. Several experiences demonstrated how often the clinical restaging overesteems neoplastic tissue by fibrosis and scar and could judge as unresectable patients with a minimal residual disease.