Unsuspected N2-positive non-small cell lung cancer after complete resection: is there a place for multimodal adjuvant therapy?

Unsuspected N2 disease after surgical resection is found in a substantial proportion of patients with locally advanced non-small cell lung cancer (NSCLC) despite adequate preoperative mediastinal staging. This situation is challenging for clinicians, as optimal adjuvant strategies remain controversial and such patients are at risk of local recurrence and distant metastasis (1,2).