The progression of non-small cell lung cancer from diagnosis to surgery

•Non-small cell lung cancers were staged using the IASLC 8th TNM classification at diagnostic CT, PET-CT and at pathology.•Tumours grew by a median of 13% (0.3 cm) between diagnostic CT and resection, with increase in T-stage in 133 patients.•N-stage increased in 51 patients, with 32 patients upstaged to N2 disease and requiring adjuvant chemotherapy.•Patients T upstaged had a reduced survival of 9.9 months and a reduced disease free survival of 8.6 months.•Some tumors show rapid growth awaiting resection, resulting in increased morbidity and mortality post-resection.