ACROBATIC Travel Grant Recipient Presents at IASLC World Conference on Lung Cancer

ACROBATIC congratulates Thomas Budolfsen, Research Assistant, who received an ACROBATIC travel grant of DKK 5,000 to participate in the IASLC World Conference on Lung Cancer (WCLC), held on 6–9 September 2025 in Barcelona, Spain.

Thomas presented his e-poster entitled: “Why Are Patients With Non-Small Cell Lung Cancer in Stage I–IIIA Considered Inoperable? A Registry Study from Denmark.”

Introduction: Surgical resection is the first-line treatment for patients with stage I-IIIA non-small cell lung cancer (NSCLC) when feasible, offering the best chance for long-term survival. However, a significant proportion of patients are deemed inoperable despite technically resectable tumors. The decision to withhold surgery is influenced by multiple factors, including tumor burden, mediastinal lymph node involvement, and patient-specific factors, necessitating a multidisciplinary team (MDT) evaluation to determine the most appropriate strategy. Methods: This retrospective registry-based cohort study included patients diagnosed with NSCLC in stage I-IIIA in the Capital Region of Denmark between January and December 2022. Patients were stratified into "Surgery" and "No Surgery" groups based on treatment records. Data on demographic variables, comorbidities, pulmonary function, performance status, and MDT decisions were extracted from the Danish Lung Cancer Registry and medical records. Logistic regression analyses identified predictors of non-surgical management. The one-year overall survival (OS) rate was estimated using the Kaplan-Meier method. Additionally, preoperative exercise testing was documented. Results: Among 524 patients with NSCLC in stage I-IIIA, 178 (34%) did not undergo surgery. Advanced age (≥ 80 years, OR 1.298), poor performance status (ECOG-PS ≥ 2, OR 1.443), comorbidities (OR 1.116), and stage IIIA disease (OR 1.181) were significantly associated with non-surgical management. The primary reasons for non-operative management in MDT decisions were low pulmonary function or poor performance status (29.2%) and comorbidities (18.0%). Notably, in 19.7% of cases, no justification for "No Surgery" was recorded. Furthermore, preoperative exercise testing was not documented for any patient. One-year OS was 95.7% in the "Surgery" group versus 82.0% in the "No Surgery" group. Conclusions: The findings of this study align with previous research, indicating that patients with stage I-IIIA NSCLC are often deemed inoperable due to comorbidities, poor performance status, or advanced age. A novel insight from this study is its documentation of the rationale for non-operative treatment, as recorded in the MDT decision-making process. Additionally, our findings indicate that exercise testing is not utilized in the assessment process, despite being recommended in current guidelines. The study also suggests a difference in overall survival between operative and non-operative treatment; however, these results should be interpreted with caution due to study limitations. Further research is needed to explore the underlying reasons for treatment decisions. Moreover, future studies could examine whether the implementation of exercise testing, as recommended, may improve the assessment of patients with lung cancer and their surgical eligibility.

Thomas shared his impressions of the conference:
“First time at the IASLC World Conference on Lung Cancer, which this year took place in Barcelona – a truly inspiring experience.
I had the pleasure of presenting an e-poster entitled ‘Why are patients with non-small cell lung cancer in stage I–IIIA considered inoperable? A registry study from Denmark’.
It was also a great opportunity to meet and connect with many talented and dedicated people – and a special thanks to Morten Quist for introducing me to this forum. A big thank you to ACROBATIC – Danish Research Center for Cancer Surgery – for supporting my participation.
I am now looking forward to an exciting time ahead with lots of new opportunities and developments!”

ACROBATIC is delighted to have supported Thomas in sharing his important research on an international stage and in fostering new collaborations within the lung cancer research community.