How to combine surgery with other therapeutic methods in lung cancer? Choosing the right patient for perioperative chemoimmunotherapy in early non-small cell lung cancer

Lung cancer treatment has evolved into a complex multidisciplinary challenge, offering patients across all stagesaccess to diverse local and systemic therapies. The introduction of effective neoadjuvant, adjuvant, and peri-adjuvantprotocols has significantly improved treatment outcomes. While surgery was once the primary treatment, it is nowoften complemented by additional therapies that enhance overall survival from pathological stage IB to IIIB. Theseadvancements necessitate changes in resectability definitions, staging, preoperative workup, surgical safety, and the roleof multidisciplinary assessment. Despite these improvements, numerous controversies persist. Identifying optimalcandidates for perioperative chemoimmunotherapy remains challenging. Patients with squamous cell histology,high PD-L1 expression, EGFR/ALK wild-type tumors, and those who are smokers with good pulmonary function testsand initially resectable to the extent of lobectomy are most likely to benefit. Tailoring treatment to these characteristicsmay enhance outcomes and maximize benefits.