Background: The paradigm of adjuvant treatment for patients in pathological stages II and III of non-small-cell lung cancer has changed toward the adjuvant combination of chemotherapy and immune checkpoint inhibitors, neoadjuvant chemoimmunotherapy, or ultimately periadjuvant chemoimmunotherapy. The introduction of a new standard requires significant changes in preoperative assessment. A real description of its current state in Poland is required, which can form the basis for systemic changes. Objectives: The aim of our study was to analyze the current standards for preoperative assessment in Poland. Design: Observational study. Methods: A comprehensive survey was conducted across seven thoracic surgery centers in Poland, focusing on preoperative pathological examination techniques, imaging methodologies, multidisciplinary team consultations, and the interval between imaging and surgical resection. Results: The survey analyzed data from 459 patients who were operated between January 2024 and October 2024. The most common pathological diagnostic methods were intraoperative frozen section, and preoperative core biopsy. Almost all patients in stages pIA-IIIB had contrast-enhanced computerized tomography (CT) of the chest, positron emission tomography (PET/CT), and bronchoscopy before surgery. In Poland, brain imaging is not a standard part of the preoperative assessment, and brain scans are obtained only exceptionally (pooled median 0% of patients in stages IA–IIIB). The median time between the CT and surgery was 61 days (range 30–90 days), and between PET/CT and surgery 35 days (range 10–66 days). The median time between the surgery and pathological report was 17 days (range 5–30 days). Multidisciplinary tumor boards are organized in the postoperative period for all patients comparing to pooled median 50% in preoperative period. In the vast majority of cases, the expression status of Programmed Death Ligand-1 and next-generation sequencing were carried out only in postoperative samples. Conclusion: Current compliance with perioperative assessment standards in Poland is inadequate. The consequence of this situation may be low availability of perioperative treatment protocols.
Marjański et al. (Sun,) studied this question.