Hello Doctor,
Seeking your opinion regarding a 71-year-old patient diagnosed with NSCLC favor squamous cell carcinoma (P40 diffuse positive, TTF1 negative) involving the right upper lobe. PET-CT shows a spiculated RUL lesion approx. 3.0 × 4.7 × 4.0 cm with SUV max 16.58. Mildly FDG-avid hilar/paratracheal nodes (SUV ~4.2) with some calcification noted. EBUS/TBNA from stations 4R, 7 and 11L showed no evidence of malignancy. Current staging documented as cT2bN1M0 (Stage IIB). Proposed plan is neoadjuvant chemotherapy followed by reassessment for surgery.
Would appreciate guidance on:
1. Whether chemo + surgery appears the optimal curative-intent approach in this case.
2. Whether adding immunotherapy to neoadjuvant chemotherapy would significantly improve outcomes.
3. Whether current imaging/EBUS findings sufficiently support N1 staging or need further nodal evaluation.
Thank you.
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