Background Management of non-small-cell lung cancer (NSCLC) is affected by regional specificities. The present study aimed at determining diagnostic and therapeutic procedures including outcome of patients with NSCLC stage III in the real-world setting in Central European countries to define areas for improvements. Patients and methods This multicentre, prospective and non-interventional study collected data of patients with NSCLC stage III in a web-based registry and analysed them centrally. Results Between March 2014 and March 2017, patients (n=583) with the following characteristics were entered: 32% females, 7% never-smokers; ECOG performance status (PS) 0, 1, 2 and 3 in 25%, 58%, 12% and 5%, respectively; 21% prior weight loss; 53% squamous carcinoma, 38% adenocarcinoma; 10% EGFR mutations. Staging procedures included chest X-ray (97% of patients), chest CT (96%), PET-CT (27%), brain imaging (20%), bronchoscopy (89%), endobronchial ultrasound (EBUS) (13%) and CT-guided biopsy (9%). Stages IIIA/IIIB were diagnosed in 55%/45% of patients, respectively. N2/N3 nodes were diagnosed in 60%/23% and pathologically confirmed in 29% of patients. Most patients (56%) were treated by combined modalities. Surgery plus chemotherapy was administered to 20%, definitive chemoradiotherapy to 34%, chemotherapy only to 26%, radiotherapy only to 12% and best supportive care (BSC) to 5% of patients. Median survival and progression-free survival times were 16.8 (15.3;18.5) and 11.2 (10.2;12.2) months, respectively. Stage IIIA, female gender, no weight loss, pathological mediastinal lymph node verification, surgery and combined modality therapy were associated with longer survival. Conclusions The real-world study demonstrated a broad heterogeneity in the management o f stage III NSCLC in Central European countries and suggested to increase the rates of PET-CT imaging, brain imaging and invasive mediastinal staging.

1st Faculty of Medicine of Charles University Prague Prague Czech Republic

Clinic for Pneumology and Tuberculosis Faculty of Medicine Masaryk University Brno Czech Republic

Clinic for Pneumology and Tuberculosis Faculty of Medicine Palacký University Olomouc Czech Republic

Clinic for Pulmonology Clinical Centre of Serbia Belgrade Serbia

Comprehensive Oncology Center and Multiscan Pardubice Czech Republic

Comprehensive Oncology Center Liberec Czech Republic

Comprehensive Oncology Center Nový Jičín Liberec Czech Republic

Department of Medicine 1 Medical University of Vienna Vienna Austria

Department of Pulmonology University Hospital Motol Prague Czech Republic

Department of Radiotherapy Medical University of Vienna Vienna Austria

Department of Thoracic Surgery Semmelweis University Budapest Hungary

Hospital of LUHS Kauno Klinikos Kauno Lithuania

Institute for Oncology and Radiology of Serbia Belgrade Serbia

Institute of Biostatistic and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Oncology Ljubljana Slovenia

National Koranyi Institute of TB and Pulmonology Budapest Hungary

Pauls Stradins Clinical University Hospital Riga Latvia

Thomayer Hospital Prague Czech Republic

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Treatment patterns and real-world evidence for stage III non-small cell lung cancer in Central and Eastern Europe