The nature of the lung nodule first needs to be clarified. Lung nodules are usually detected by low-dose computed tomography (LDCT) of the chest, but to confirm the nature of the nodule, a non-surgical biopsy (tracheoscopy or puncture biopsy) histopathology is first required to confirm the diagnosis.
If a non-surgical biopsy is not possible, artificial intelligence (AI) may be considered to assist in the diagnosis. Surgical (thoracoscopic) biopsy may be considered if tissue cannot be obtained on non-surgical biopsy, but AI-assisted expert review or multidisciplinary consultation (MDT) suspects a high degree of malignancy in the lung nodule.
When no decision can be made, follow-up observation may be considered.
If malignant, treatment according to consensus guidelines, mainly surgery, is required. Non-surgical treatment, such as radiotherapy or radiofrequency ablation, may be considered for those who cannot tolerate it.
For patients with early stage lung cancer (i.e. carcinoma in situ and stage IA lung cancer) in lung nodules, post-operative management is mainly to improve anti-tumour immune function to prevent recurrence and metastasis; for those with non-early stage lung cancer, post-operative management needs to be enhanced or even given appropriate treatment such as chemotherapy, targeted or immunotherapy.