2026 Revised Recommendations of The American Association for Thoracic Surgery (AATS) 2023 Expert Consensus Document: Staging and multidisciplinary management of patients with early-stage non-small cell lung cancer.

Diagnosis, staging, and treatment of early-stage lung cancer remains an important area of thoracic surgical oncology. The previous AATS expert consensus document, published in 2023, reflected critical recommendations for the workup and management of this disease, including the adoption of chemoimmunotherapy as standard of care for locally advanced patients without targetable mutations. Since that publication, there have been additional publications which provide further insight into the management of these patients. This revised document seeks to refine best practice standards in regard to staging and diagnosis, neoadjuvant treatment, surgical management, and post-operative therapy of these patient based on the currently available data. Key modifications made to the previous version reflect additional randomized trials supporting the efficacy of pre-operative or peri-operative chemoimmunotherapy, adjuvant targeted therapy for eligible patients, and evolving practice standards regarding adjuvant immunotherapy for previously untreated patients. In addition, the current document continues to support the critical need for accurate diagnosis and staging of non-metastatic patients, including an emphasis on molecular diagnostics, as well as multi-disciplinary evaluation of patients who are eligible for multi-modality treatment.