The analysis of current international recommendations for the treatment of patients with stage III non-small cell lung cancer

The development of systemic antitumor treatment, targeted therapy and immune checkpoint inhibitor therapy (ICI) has changed the treatment outcome and prognosis for locally advanced non-small cell lung cancer (NSCLC). Modern recommendations provide for the division of such patients into potentially resectable and unresectable, and such division does not always correspond to stage IIIa, IIIb or IIIc of the disease. The treatment of resectable tumors is recommended to start with neoadjuvant chemoimmunotherapy (CIT), followed by surgical intervention aimed at radical tumor removal only in patients who respond to treatment. For unresectable tumors, the best approach is considered to be simultaneous chemoradiation therapy (CRT) followed by adjuvant ICI therapy, and the role of surgical interventions is limited to salvage surgery – residual tumor or local relapse removal after non-surgical self-treatment.This approach to the treatment of patients with stage III NSCLC is unlikely to fully satisfy specialists and patients – there is no complete consensus on the definition of the term «resectability»; the possibility of converting an unresect able tumor into a resectable one as a result of neoadjuvant treatment is denied, which is contrary to clinical practice. The objective of the article was the critical analysis of existing recommendations on the role of the surgical approach as a stage of complex treatment of stage III NSCLC from the surgeon’s point of view.