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Functional Recovery as a Survivorship Endpoint in Early-Stage NSCLC
Giovanni Leuzzi1, Filippo Lococo2,3, Beatrice Cosentino1
1Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
Cancers
|June 26, 2026
Summary
Long-term survivors of early-stage non-small cell lung cancer (NSCLC) often face functional decline. Focusing on functional recovery alongside survival metrics is crucial for improving survivorship after NSCLC treatment.
Area of Science:
- Oncology
- Gerontology
- Rehabilitation Medicine
Background:
- Advances in early-stage non-small cell lung cancer (NSCLC) treatment increase long-term survivors.
- Disease-free survival in NSCLC survivors does not guarantee full functional recovery.
- Patients often experience persistent fatigue, dyspnea, reduced activity, and decreased quality of life post-treatment.
Purpose of the Study:
- To review functional recovery as a critical survivorship endpoint in early-stage NSCLC.
- To explore factors influencing functional recovery trajectories and identify vulnerable patients.
- To advocate for integrated survivorship models combining oncologic and functional outcomes.
Main Methods:
- Narrative review of literature on functional recovery in early-stage NSCLC.
- Discussion of recovery trajectories, physiologic vulnerability, frailty, and sarcopenia.
- Examination of rehabilitation, symptom burden, and biologic frameworks like allostatic load.
Main Results:
- Functional recovery post-NSCLC treatment is heterogeneous and influenced by multiple factors.
- Factors include baseline reserve, inflammation, inactivity, behavioral adaptation, and cumulative stress.
- Survivorship should incorporate physiologic reserve, autonomy, and daily functioning, not just recurrence metrics.
Conclusions:
- Survivorship assessment for early-stage NSCLC should include functional recovery.
- Rehabilitation, symptom surveillance, and patient-reported outcomes can aid vulnerable patients.
- Future models must integrate oncologic outcomes with longitudinal functional assessments for comprehensive recovery characterization.
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