Revisiting patient preference in resectable and irradiable stage III NSCLC in the immunotherapy era

The optimal local treatment for resectable stage III non-small cell lung cancer (NSCLC) remains controversial, with both surgery and radiotherapy considered valid options depending on tumor characteristics, comorbidities, and institutional expertise. The introduction of immunotherapy has improved outcomes in surgery- as well as radiotherapy-based treatment approaches. Current ESMO and NCCN guidelines demonstrate both consensus and discrepancies in N2 NSCLC. When both surgery and radiotherapy are feasible, patient preference should be considered in decision-making, supported by multidisciplinary discussion and current evidence.