Multidisciplinary questions in thoracic oncology: the team experience.

In the context of the European Respiratory Society (ERS) plan for thoracic oncology [1], in 2014 the European Respiratory Journal (ERJ) initiated a series of reviews called “Challenges and controversies in thoracic oncology” [2]. The following questions were addressed. The specific contribution of each thoracic staging and treatment modality has not always been unequivocally established: which grey areas remain? Concerning screening programmes for lung cancer, is it time for large-scale screening via chest computed tomography? Is multidisciplinary team management in thoracic oncology more than a concept? Considering tumour tissue sampling for lung cancer management at the era of personalised therapy, what is enough for molecular testing? Which approaches should be used for small sized lung cancer: lobectomy, sublobectomy or stereotactic irradiation? What is the place of multimodality management of malignant pleural mesothelioma? How can non-inferiority trials influence practice in thoracic oncology without valid conclusions? How should advanced nonsmall cell lung cancer (NSCLC) be treated: by targeted therapy, personalised chemotherapy or standard chemotherapy? What is the exact role of palliative care in the patient’s management? What should be the approach to the staging of lung cancer, with regard to noninvasive, minimally invasive and invasive techniques? Which examinations (and at what time) should take place during the follow-up of the patient after lung cancer resection? What is the best management option for a patient with NSCLC, with an epidermal growth factor receptor activating mutation or with an Alk translocation?