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2026 Revised recommendations of the American Association for Thoracic Surgery (AATS) 2023 Expert Consensus Document: Staging and multidisciplinary management of patients with early-stage non–small cell lung cancer

The Journal of Thoracic and Cardiovascular Surgery·September 25Open Access
Respiratory SystemPractice changingNon-Small Cell Lung CancerClinical Practice GuidelineChemoimmunotherapyImmunotherapySurgical OncologyTargeted TherapyAdult

Summary

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What was studied

This revised AATS Expert Consensus Document evaluates updated best-practice standards for staging, diagnosis, neoadjuvant treatment, surgical management, and postoperative therapy of early-stage non–small cell lung cancer (NSCLC), incorporating evidence published since the 2023 original document.

Key findings

Key updates include: (1) additional RCT evidence supporting preoperative or perioperative chemoimmunotherapy, (2) adjuvant targeted therapy for eligible patients with actionable mutations, and (3) evolving standards for adjuvant immunotherapy in previously untreated patients; multidisciplinary evaluation and molecular diagnostics remain strongly emphasized.

Study limitations

As a consensus document rather than a primary study, recommendations reflect expert interpretation of available data and may lag behind rapidly evolving trial evidence; no original patient-level data or statistical outcomes are reported.

Clinical implications

For patients with early-stage NSCLC, clinicians should pursue accurate molecular staging and involve a multidisciplinary team; perioperative chemoimmunotherapy is now supported by multiple RCTs, and adjuvant targeted therapy should be offered to eligible patients with actionable mutations.

Caveats

  • Recommendations regarding adjuvant immunotherapy for previously untreated patients reflect rapidly evolving evidence; clinicians should monitor for further trial updates that may supersede these guidelines
  • The document focuses on nonmetastatic (early-stage) NSCLC only; conclusions should not be generalized to metastatic or small cell lung cancer populations
  • This is an expert consensus/guideline update, not a primary research study — no original efficacy or safety data are reported, and recommendations are based on synthesis of existing trial evidence

Related Questions

Explore related topics

What randomized trials support perioperative chemoimmunotherapy for resectable non-small cell lung cancer?Adjuvant targeted therapy for EGFR-mutant or ALK-positive early-stage NSCLC: current evidence and guidelinesMultidisciplinary staging workup and molecular diagnostics for early-stage lung cancer: best practices

Publication Details

Year
2026
Journal
The Journal of Thoracic and Cardiovascular Surgery
Source
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