The first analysis of stage III non-small cell lung cancer (NSCLC) management and outcomes were presented using the National Lung Cancer Audit data. In this study, patients diagnosed with stage III NSCLC in 2016 were identified. Linked datasets (including Hospital Statistics, pathology reports, and death certificates) were used to categorize the received treatment. Kaplan–Meier survival curves were obtained, with survival defined from the date of diagnosis to death. In total, 6,276 cases of stage III NSCLC were analyzed, out of which 3,827 were marked stage IIIA and 2,449 stage IIIB. About 1,047 patients were treated with radical radiotherapy, among which 676 also received chemotherapy.

Twenty percent of patients with stage IIIA disease underwent surgery, with half of these also receiving chemotherapy, predominantly delivered in the adjuvant setting. Of note, 2148 patients received palliative-intent treatment, and 2265  received no active anti-cancer treatment. The critical gaps in the optimal care of patients with stage III NSCLC were highlighted. Multimodality treatments with either radical radiotherapy or surgery combined with chemotherapy were administered to less than one-fifth of patients, even though these treatment plans are considered optimal for survival. In conclusion, access to specialized resources and staff, the practice of effectively shared decision making, and challenging prejudices can optimize management.