BackTable Vascular & Interventional Ep. 591 NSCLC Tumor Board Discussion: Considerations for Oligometastatic Disease with Dr. Karen Reckamp, Dr. Scott Atay, Dr. Scott Oh and Dr. Alan Lee
Nov 21, 2025
Join Dr. Karen Reckamp, a medical oncologist focused on neoadjuvant strategies, Dr. Scott Oh, a radiation oncologist discussing local therapies, and Dr. Scott Atay, an interventional pulmonologist specializing in staging, as they tackle a complex NSCLC case. They debate the best approaches for treating isolated brain metastasis, the implications of nodal disease, and the optimal sequencing of chemoimmunotherapy and radiation. Their multidisciplinary insights shed light on the balance between surgical risks and systemic benefits in challenging cancer cases.
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Multidisciplinary Workup First
- Start multidisciplinary evaluation before biopsy to plan staging and management.
- Coordinate interventional pulmonology, medical oncology, and surgery up front to avoid unnecessary procedures.
Do Invasive Mediastinal Staging
- Perform invasive mediastinal staging when a large central lung mass has suspicious nodes.
- Sample both the primary and nodes to avoid under-staging before definitive therapy.
Node Biopsy Changed Staging
- The team biopsied a station 11 node and confirmed squamous carcinoma with no other spread.
- That sampling changed initial staging from presumed T4N0 to T4N1 before brain MRI.