Our multidisciplinary thoracic oncology tumor board is dynamic and a highlight of the week, facilitated in equal parts by the fact that our group genuinely enjoys each other’s company and that it is the source of some engaging debate about the potential best way to manage several complex scenarios in lung cancer. There are a few that have become recurring debates, among them the question of whether to pursue surgery for a patient with a locally advanced NSCLC, perhaps felt to be unresectable or on the outer limits of resectability, who has undergone chemotherapy and concurrent radiation to a potentially curative dose, has encouraging but ambiguous imaging findings, and is now being considered for surgery. Essentially, this is a troubling struggle of trying to balance our concern for over-treating vs. potentially under-treating this patient.

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