Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Lunxu ¹ , GAO Shugeng ² , HE Jianxing ³ , HU Jian ⁴ , GE Di ⁵ , LI Hecheng ⁶ , KANG Mingqiang ⁷ , TAN Fengwei ² , YANG Fan ⁸ , PU Qiang ¹ ,  CAI Kaican ⁹ , Chinese Medical Doctor Association Thoracic Surgeons Branch , Thoracic Surgery Society of China Medical Education Association

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, P. R. China;
3. Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, P. R. China;
4. Department of General Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, P. R. China;
5. Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China;
6. Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P. R. China;
7. Department of Thoracic Surgery, Union Hospital, Fujian Medical University, Fuzhou, 350001, P. R. China;
8. Department of Thoracic Surgery, Peking University People's Hospital, Beijing, 100044, P. R. China;
9. Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, P. R. China;

Corresponding author：

CAI Kaican, Email: doc_cai@163.com

Keywords：

Non-small cell lung cancer; postoperative follow-up; thoracic surgery; expert consensus

DOI：

10.7507/1007-4848.202501057

Video：

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Abstract Full text Figures/Tables Video References Cited by

Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.

Citation： LIU Lunxu, GAO Shugeng, HE Jianxing, HU Jian, GE Di, LI Hecheng, KANG Mingqiang, TAN Fengwei, YANG Fan, PU Qiang, CAI Kaican, Chinese Medical Doctor Association Thoracic Surgeons Branch, Thoracic Surgery Society of China Medical Education Association. Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025). Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(3): 281-290. doi: 10.7507/1007-4848.202501057 Copy

1.	刘伦旭, 高树庚, 何建行, 等. 非小细胞肺癌术后随访中国胸外科专家共识. 中国胸心血管外科临床杂志, 2021, 28(1): 4-10.Liu LX, Gao SG, He JX, et al. Chinese expert consensus on postoperative follow-up for non-small cell lung cancer. Chin J Clin Thorac Cardiovasc Surg, 2021, 28(1): 4-10.
2.	Bayarri-Lara CI, de Miguel Perez D, Cueto Ladron De Guevara A, et al. Association of circulating tumour cells with early relapse and ¹⁸F-fluorodeoxyglucose positron emission tomography uptake in resected non-small-cell lung cancers. Eur J Cardiothorac Surg, 2017, 52(1): 55-62.
3.	Cho A, Hur J, Hong YJ, et al. Prognostic impact of cytological fluid tumor markers in non-small cell lung cancer. Tumour Biol, 2016, 37(3): 3205-3213.
4.	Reinmuth N, Brandt B, Semik M, et al. Prognostic impact of Cyfra21-1 and other serum markers in completely resected non-small cell lung cancer. Lung Cancer, 2002, 36(3): 265-270.
5.	Wang L, Wang D, Zheng G, et al. Clinical evaluation and therapeutic monitoring value of serum tumor markers in lung cancer. Int J Biol Markers, 2016, 31(1): e80-e87.
6.	Chiu C, Chern M, Wu M, et al. Usefulness of low-dose spiral CT of the chest in regular follow-up of postoperative non-small cell lung cancer patients: Preliminary report. J Thorac Cardiovasc Surg, 2003, 125(6): 1300-1305.
7.	Lee J, Lee Y, Park K, et al. Fate of newly detected lesions during postoperative surveillance for non-small cell lung cancer. Ann Thorac Surg, 2013, 95(6): 1867-1871.
8.	Schneider BJ, Ismaila N, Aerts J, et al. Lung cancer surveillance after definitive curative-intent therapy: ASCO guideline. J Clin Oncol, 2020, 38(7): 753-766.
9.	Westeel V, Choma D, Clement F, et al. Relevance of an intensive postoperative follow-up after surgery for non-small cell lung cancer. Ann Thorac Surg, 2000, 70(4): 1185-1190.
10.	Xi J, Yin J, Wang L, et al. A surveillance method-oriented detection of post-operative spatia-temporal recurrence for non-small cell lung cancer. J Thorac Dis, 2018, 10(11): 6107-6117.
11.	Sanchez De Cos J, Sojo Gonzalez MA, Montero MV, et al. Non-small cell lung cancer and silent brain metastasis. Survival and prognostic factors. Lung Cancer, 2009, 63(1): 140-145.
12.	张炜, 郭万华. ^99mTc-MDP全身骨扫描和血清CEA、NSE、CYFR21-1、CA125测定对小细胞肺癌骨转移的临床评价. 东南大学学报(医学版), 2015, 34(6): 881-885.Zhang W, Guo WH. Clinical evaluation of ^99mTc-MDP bone scintigraphy and serum CEA, NSE, CYFRA21-1 and CA125 in skeletal metastasis of the small cell lung cancer. J Southeast Univ (Med Sci Edi ), 2015, 34(6): 881-885.
13.	Mac Manus M, Hicks RJ. The use of positron emission tomography (PET) in the staging/evaluation, treatment, and follow-up of patients with lung cancer: A critical review. Int J RadⅠAt Oncol Biol Phys, 2008, 72(5): 1298-1306.
14.	Hicks RJ, Kalff V, MacManus MP, et al. The utility of ¹⁸F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: Impact on management and prognostic stratification. J Nucl Med, 2001, 42(11): 1605-1613.
15.	Toba H, Sakiyama S, Otsuka H, et al. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg, 2012, 15(5): 859-864.
16.	Mollberg NM, Ferguson MK. Postoperative surveillance for non-small cell lung cancer resected with curative intent: Developing a patient-centered approach. Ann Thorac Surg, 2013, 95(3): 1112-1121.
17.	Chabon JJ, Hamilton EG, Kurtz DM, et al. Integrating genomic features for non-invasive early lung cancer detection. Nature, 2020, 580(7802): 245-251.
18.	Zviran A, Schulman RC, Shah M, et al. Genome-wide cell-free DNA mutational integration enables ultra-sensitive cancer monitoring. Nat Med, 2020, 26(7): 1114-1124.
19.	Chen K, Zhao H, Shi Y, et al. Perioperative dynamic changes in circulating tumor DNA in patients with lung cancer (DYNAMIC). Clin Cancer Res, 2019, 25(23): 7058-7067.
20.	Zhang J, Liu S, Gao W, et al. Longitudinal undetectable molecular residual disease defines potentially cured population in localized non-small cell lung cancer. Cancer Discov, 2022, 12(7): 1690-1701.
21.	Ito H, Suzuki K, Mizutani T, et al. Long-term survival outcome after lobectomy in patients with clinical T1N0 lung cancer. J Thorac Cardiovasc Surg, 2020. Epub ahead print.
22.	Suzuki K, Watanabe S, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
23.	Aokage K, Suzuki K, Saji H, et al. Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): A multicentre, single-arm, confirmatory, phase 3 trial. Lancet Respir Med, 2023, 11(6): 540-549.
24.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
25.	Altorki N, Wang X, Kozono D, et al. Lobar or sublobar resection for peripheral stageⅠA non-small-cell lung cancer. N Engl J Med, 2023, 388(6): 489-498.
26.	Gauger J, Patz EFJ, Coleman RE, et al. Clinical stageⅠnon-small cell lung cancer including FDG-PET Imaging: Sites and time to recurrence. J Thorac Oncol, 2007, 2(6): 499-505.
27.	Lee K, Kim HR, Kim DK, et al. Post-recurrence survival analysis of stageⅠnon-small-cell lung cancer. Asian Cardiovasc Thorac Ann, 2017, 25(9): 623-629.
28.	Li J, Yang X, Xia T, et al. StageⅠsynchronous multiple primary non-small cell lung cancer: CT findings and the effect of TNM staging with the 7th and 8th editions on prognosis. J Thorac Dis, 2017, 9(12): 5335-5344.
29.	Soh J, Toyooka S, Shintani Y, et al. Limited resection for stageⅠA radiologically invasive lung cancer: A real-world nationwide database study. Eur J Cardiothorac Surg, 2022, 62(1): ezac342 .
30.	Moreira AL, Ocampo PSS, Xia Y, et al. A grading system for invasive pulmonary adenocarcinoma: A proposal from the International Association for the Study of Lung Cancer Pathology Committee. J Thorac Oncol, 2020, 15(10): 1599-1610.
31.	Woo W, Cha Y, Kim BJ, et al. Validation study of new IASLC histology grading system in stage Ⅰ non-mucinous adenocarcinoma comparing with minimally invasive adenocarcinoma. Clin Lung Cancer, 2022, 23(7): e435-e442.
32.	Xu L, Su H, Hou L, et al. The IASLC proposed grading system accurately predicts prognosis and mediastinal nodal metastasis in patients with clinical stageⅠlung adenocarcinoma. Am J Surg Pathol, 2022, 46(12): 1633-1641.
33.	Kadota K, Nitadori J, Sima CS, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stageⅠlung adenocarcinomas. J Thorac Oncol, 2015, 10(5): 806-814.
34.	Eguchi T, Kameda K, Lu S, et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: A propensity score-matched analysis. J Thorac Oncol, 2019, 14(1): 87-98.
35.	Shiono S, Endo M, Suzuki K, et al. Spread through air spaces is a prognostic factor in sublobar resection of non-small cell lung cancer. Ann Thorac Surg, 2018, 106(2): 354-360.
36.	Cai J, Wang X, Yang F, et al. Lymphovascular invasion: A non-sized T descriptor for stageⅠA non-small cell lung cancer. Thorac Cancer, 2022, 13(17): 2413-2420.
37.	Wang S, Zhang B, Qian J, et al. Proposal on incorporating lymphovascular invasion as a T-descriptor for stageⅠlung cancer. Lung Cancer, 2018, 125: 245-252.
38.	Fick CN, Dunne EG, Toumbacaris N, et al. Late recurrence of completely resected stageⅠto ⅢA lung adenocarcinoma. J Thorac Cardiovasc Surg, 2025, 169(2): 445-453.
39.	Seto K, Kuroda H, Yoshida T, et al. Higher frequency of occult lymph node metastasis in clinical N0 pulmonary adenocarcinoma with ALK rearrangement. Cancer Manag Res, 2018, 10: 2117-2124.
40.	Mizuno T, Yatabe Y, Kuroda H, et al. Impact of the oncogenic status on the mode of recurrence in resected non-small cell lung cancer. Jpn J Clin Oncol, 2016, 46(10): 928-934.
41.	Kim MH, Shim HS, Kang DR, et al. Clinical and prognostic implications of ALK and ROS1 rearrangements in never-smokers with surgically resected lung adenocarcinoma. Lung Cancer, 2014, 83(3): 389-395.
42.	Yang P, Kulig K, Boland JM, et al. Worse disease-free survival in never-smokers with ALK+ lung adenocarcinoma. J Thorac Oncol, 2012, 7(1): 90-97.
43.	Gourmet A, Ferrari V. AlectinⅠB in resected ALK-positive non-small-cell lung cancer. Bull Cancer, 2024, 111(10): 905-906.
44.	Felip E, Altorki N, Zhou C, et al. Adjuvant atezolizumab after adjuvant chemotherapy in resected stageⅠB-ⅢA non-small-cell lung cancer (IMpower010): A randomised, multicentre, open-label, phase 3 trial. Lancet, 2021, 398(10308): 1344-1357.
45.	O'Brien M, Paz-Ares L, Marreaud S, et al. Pembrolizumab versus placebo as adjuvant therapy for completely resected stageⅠB-ⅢA non-small-cell lung cancer (PEARLS/KEYNOTE-091): An interim analysis of a randomised, triple-blind, phase 3 trial. Lancet Oncol, 2022, 23(10): 1274-1286.
46.	Heymach JV, Mitsudomi T, Harpole D, et al. Design and rationale for a phase Ⅲ, double-blind, placebo-controlled study of neoadjuvant durvalumab + chemotherapy followed by adjuvant durvalumab for the treatment of patients with resectable stagesⅡ and Ⅲ non-small-cell lung cancer: The AEGEAN Trial. Clin Lung Cancer, 2022, 23(3): e247-e251.
47.	Spicer JD, Garassino MC, Wakelee H, et al. Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone in patients with early-stage non-small-cell lung cancer (KEYNOTE-671): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, 2024, 404(10459): 1240-1252.
48.	Lu S, Zhang W, Wu L, et al. Perioperative toripalimab plus chemotherapy for patients with resectable non-small cell lung cancer: The Neotorch randomized clinical trial. JAMA, 2024, 331(3): 201-211.
49.	Forde PM, Spicer J, Lu S, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med, 2022, 386(21): 1973-1985.
50.	Cascone T, Awad MM, Spicer JD, et al. Perioperative nivolumab in resectable lung cancer. N Engl J Med, 2024, 390(19): 1756-1769.

1. 刘伦旭, 高树庚, 何建行, 等. 非小细胞肺癌术后随访中国胸外科专家共识. 中国胸心血管外科临床杂志, 2021, 28(1): 4-10.Liu LX, Gao SG, He JX, et al. Chinese expert consensus on postoperative follow-up for non-small cell lung cancer. Chin J Clin Thorac Cardiovasc Surg, 2021, 28(1): 4-10.
2. Bayarri-Lara CI, de Miguel Perez D, Cueto Ladron De Guevara A, et al. Association of circulating tumour cells with early relapse and ¹⁸F-fluorodeoxyglucose positron emission tomography uptake in resected non-small-cell lung cancers. Eur J Cardiothorac Surg, 2017, 52(1): 55-62.
3. Cho A, Hur J, Hong YJ, et al. Prognostic impact of cytological fluid tumor markers in non-small cell lung cancer. Tumour Biol, 2016, 37(3): 3205-3213.
4. Reinmuth N, Brandt B, Semik M, et al. Prognostic impact of Cyfra21-1 and other serum markers in completely resected non-small cell lung cancer. Lung Cancer, 2002, 36(3): 265-270.
5. Wang L, Wang D, Zheng G, et al. Clinical evaluation and therapeutic monitoring value of serum tumor markers in lung cancer. Int J Biol Markers, 2016, 31(1): e80-e87.
6. Chiu C, Chern M, Wu M, et al. Usefulness of low-dose spiral CT of the chest in regular follow-up of postoperative non-small cell lung cancer patients: Preliminary report. J Thorac Cardiovasc Surg, 2003, 125(6): 1300-1305.
7. Lee J, Lee Y, Park K, et al. Fate of newly detected lesions during postoperative surveillance for non-small cell lung cancer. Ann Thorac Surg, 2013, 95(6): 1867-1871.
8. Schneider BJ, Ismaila N, Aerts J, et al. Lung cancer surveillance after definitive curative-intent therapy: ASCO guideline. J Clin Oncol, 2020, 38(7): 753-766.
9. Westeel V, Choma D, Clement F, et al. Relevance of an intensive postoperative follow-up after surgery for non-small cell lung cancer. Ann Thorac Surg, 2000, 70(4): 1185-1190.
10. Xi J, Yin J, Wang L, et al. A surveillance method-oriented detection of post-operative spatia-temporal recurrence for non-small cell lung cancer. J Thorac Dis, 2018, 10(11): 6107-6117.
11. Sanchez De Cos J, Sojo Gonzalez MA, Montero MV, et al. Non-small cell lung cancer and silent brain metastasis. Survival and prognostic factors. Lung Cancer, 2009, 63(1): 140-145.
12. 张炜, 郭万华. ^99mTc-MDP全身骨扫描和血清CEA、NSE、CYFR21-1、CA125测定对小细胞肺癌骨转移的临床评价. 东南大学学报(医学版), 2015, 34(6): 881-885.Zhang W, Guo WH. Clinical evaluation of ^99mTc-MDP bone scintigraphy and serum CEA, NSE, CYFRA21-1 and CA125 in skeletal metastasis of the small cell lung cancer. J Southeast Univ (Med Sci Edi ), 2015, 34(6): 881-885.
13. Mac Manus M, Hicks RJ. The use of positron emission tomography (PET) in the staging/evaluation, treatment, and follow-up of patients with lung cancer: A critical review. Int J RadⅠAt Oncol Biol Phys, 2008, 72(5): 1298-1306.
14. Hicks RJ, Kalff V, MacManus MP, et al. The utility of ¹⁸F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: Impact on management and prognostic stratification. J Nucl Med, 2001, 42(11): 1605-1613.
15. Toba H, Sakiyama S, Otsuka H, et al. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients. Interact Cardiovasc Thorac Surg, 2012, 15(5): 859-864.
16. Mollberg NM, Ferguson MK. Postoperative surveillance for non-small cell lung cancer resected with curative intent: Developing a patient-centered approach. Ann Thorac Surg, 2013, 95(3): 1112-1121.
17. Chabon JJ, Hamilton EG, Kurtz DM, et al. Integrating genomic features for non-invasive early lung cancer detection. Nature, 2020, 580(7802): 245-251.
18. Zviran A, Schulman RC, Shah M, et al. Genome-wide cell-free DNA mutational integration enables ultra-sensitive cancer monitoring. Nat Med, 2020, 26(7): 1114-1124.
19. Chen K, Zhao H, Shi Y, et al. Perioperative dynamic changes in circulating tumor DNA in patients with lung cancer (DYNAMIC). Clin Cancer Res, 2019, 25(23): 7058-7067.
20. Zhang J, Liu S, Gao W, et al. Longitudinal undetectable molecular residual disease defines potentially cured population in localized non-small cell lung cancer. Cancer Discov, 2022, 12(7): 1690-1701.
21. Ito H, Suzuki K, Mizutani T, et al. Long-term survival outcome after lobectomy in patients with clinical T1N0 lung cancer. J Thorac Cardiovasc Surg, 2020. Epub ahead print.
22. Suzuki K, Watanabe S, Wakabayashi M, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. J Thorac Cardiovasc Surg, 2022, 163(1): 289-301.
23. Aokage K, Suzuki K, Saji H, et al. Segmentectomy for ground-glass-dominant lung cancer with a tumour diameter of 3 cm or less including ground-glass opacity (JCOG1211): A multicentre, single-arm, confirmatory, phase 3 trial. Lancet Respir Med, 2023, 11(6): 540-549.
24. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
25. Altorki N, Wang X, Kozono D, et al. Lobar or sublobar resection for peripheral stageⅠA non-small-cell lung cancer. N Engl J Med, 2023, 388(6): 489-498.
26. Gauger J, Patz EFJ, Coleman RE, et al. Clinical stageⅠnon-small cell lung cancer including FDG-PET Imaging: Sites and time to recurrence. J Thorac Oncol, 2007, 2(6): 499-505.
27. Lee K, Kim HR, Kim DK, et al. Post-recurrence survival analysis of stageⅠnon-small-cell lung cancer. Asian Cardiovasc Thorac Ann, 2017, 25(9): 623-629.
28. Li J, Yang X, Xia T, et al. StageⅠsynchronous multiple primary non-small cell lung cancer: CT findings and the effect of TNM staging with the 7th and 8th editions on prognosis. J Thorac Dis, 2017, 9(12): 5335-5344.
29. Soh J, Toyooka S, Shintani Y, et al. Limited resection for stageⅠA radiologically invasive lung cancer: A real-world nationwide database study. Eur J Cardiothorac Surg, 2022, 62(1): ezac342 .
30. Moreira AL, Ocampo PSS, Xia Y, et al. A grading system for invasive pulmonary adenocarcinoma: A proposal from the International Association for the Study of Lung Cancer Pathology Committee. J Thorac Oncol, 2020, 15(10): 1599-1610.
31. Woo W, Cha Y, Kim BJ, et al. Validation study of new IASLC histology grading system in stage Ⅰ non-mucinous adenocarcinoma comparing with minimally invasive adenocarcinoma. Clin Lung Cancer, 2022, 23(7): e435-e442.
32. Xu L, Su H, Hou L, et al. The IASLC proposed grading system accurately predicts prognosis and mediastinal nodal metastasis in patients with clinical stageⅠlung adenocarcinoma. Am J Surg Pathol, 2022, 46(12): 1633-1641.
33. Kadota K, Nitadori J, Sima CS, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stageⅠlung adenocarcinomas. J Thorac Oncol, 2015, 10(5): 806-814.
34. Eguchi T, Kameda K, Lu S, et al. Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: A propensity score-matched analysis. J Thorac Oncol, 2019, 14(1): 87-98.
35. Shiono S, Endo M, Suzuki K, et al. Spread through air spaces is a prognostic factor in sublobar resection of non-small cell lung cancer. Ann Thorac Surg, 2018, 106(2): 354-360.
36. Cai J, Wang X, Yang F, et al. Lymphovascular invasion: A non-sized T descriptor for stageⅠA non-small cell lung cancer. Thorac Cancer, 2022, 13(17): 2413-2420.
37. Wang S, Zhang B, Qian J, et al. Proposal on incorporating lymphovascular invasion as a T-descriptor for stageⅠlung cancer. Lung Cancer, 2018, 125: 245-252.
38. Fick CN, Dunne EG, Toumbacaris N, et al. Late recurrence of completely resected stageⅠto ⅢA lung adenocarcinoma. J Thorac Cardiovasc Surg, 2025, 169(2): 445-453.
39. Seto K, Kuroda H, Yoshida T, et al. Higher frequency of occult lymph node metastasis in clinical N0 pulmonary adenocarcinoma with ALK rearrangement. Cancer Manag Res, 2018, 10: 2117-2124.
40. Mizuno T, Yatabe Y, Kuroda H, et al. Impact of the oncogenic status on the mode of recurrence in resected non-small cell lung cancer. Jpn J Clin Oncol, 2016, 46(10): 928-934.
41. Kim MH, Shim HS, Kang DR, et al. Clinical and prognostic implications of ALK and ROS1 rearrangements in never-smokers with surgically resected lung adenocarcinoma. Lung Cancer, 2014, 83(3): 389-395.
42. Yang P, Kulig K, Boland JM, et al. Worse disease-free survival in never-smokers with ALK+ lung adenocarcinoma. J Thorac Oncol, 2012, 7(1): 90-97.
43. Gourmet A, Ferrari V. AlectinⅠB in resected ALK-positive non-small-cell lung cancer. Bull Cancer, 2024, 111(10): 905-906.
44. Felip E, Altorki N, Zhou C, et al. Adjuvant atezolizumab after adjuvant chemotherapy in resected stageⅠB-ⅢA non-small-cell lung cancer (IMpower010): A randomised, multicentre, open-label, phase 3 trial. Lancet, 2021, 398(10308): 1344-1357.
45. O'Brien M, Paz-Ares L, Marreaud S, et al. Pembrolizumab versus placebo as adjuvant therapy for completely resected stageⅠB-ⅢA non-small-cell lung cancer (PEARLS/KEYNOTE-091): An interim analysis of a randomised, triple-blind, phase 3 trial. Lancet Oncol, 2022, 23(10): 1274-1286.
46. Heymach JV, Mitsudomi T, Harpole D, et al. Design and rationale for a phase Ⅲ, double-blind, placebo-controlled study of neoadjuvant durvalumab + chemotherapy followed by adjuvant durvalumab for the treatment of patients with resectable stagesⅡ and Ⅲ non-small-cell lung cancer: The AEGEAN Trial. Clin Lung Cancer, 2022, 23(3): e247-e251.
47. Spicer JD, Garassino MC, Wakelee H, et al. Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab compared with neoadjuvant chemotherapy alone in patients with early-stage non-small-cell lung cancer (KEYNOTE-671): A randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, 2024, 404(10459): 1240-1252.
48. Lu S, Zhang W, Wu L, et al. Perioperative toripalimab plus chemotherapy for patients with resectable non-small cell lung cancer: The Neotorch randomized clinical trial. JAMA, 2024, 331(3): 201-211.
49. Forde PM, Spicer J, Lu S, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med, 2022, 386(21): 1973-1985.
50. Cascone T, Awad MM, Spicer JD, et al. Perioperative nivolumab in resectable lung cancer. N Engl J Med, 2024, 390(19): 1756-1769.

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Interpretation of neoadjuvant and adjuvant treatments for early stage resectable non-small cell lung cancer: Consensus recommendations from the International Association for the Study of Lung Cancer

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025)

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