Counseling Patients on PCR, Residual Disease, and the Role of Adjuvant Therapy After DFLOT

This segment focuses on how pathologic complete response, major response, and residual nodal disease inform postoperative counseling and decisions about completing a full year of adjuvant immunotherapy after DFLOT. The panel explains that PCR is an encouraging milestone that can support discussions about prognosis and may help guide decisions when patients experience significant toxicity. Even so, PCR is not a guarantee of long term disease control, and patients still require structured surveillance. The conversation then turns to the opposite scenario, when residual nodal disease remains after neoadjuvant therapy. The panel notes that node positive status after treatment is strongly associated with poorer outcomes, which is why clinicians often recommend completing the full planned course of adjuvant therapy whenever feasible. The discussion also highlights the growing interest in integrating tools such as ctDNA, although access varies. The segment concludes with the importance of accurate staging, including staging laparoscopy for appropriate patients, and summarizes key takeaways that support the emerging practice model for DFLOT should regulatory approval occur.