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This narrative review explores how circadian and circannual rhythms act as silent drivers of oncological prognosis, deeply influencing the interaction between host immunity and tumor behavior. Evidence suggests that the integrity of the molecular clock, regulated by genes such as TIMELESS and RORA, is not merely a biochemical detail but a critical determinant of survival and metastatic potential. Furthermore, environmental cues like Vitamin D synthesis and photoperiodism introduce seasonal fluctuations in patient resilience, creating specific \u201cwindows of vulnerability\u201d during surgical stress. Moving toward a \u201ctime-aware\u201d oncology opens the possibility of synchronizing clinical interventions\u2014from the hour\/season of surgery to immunotherapy scheduling\u2014with the patient\u2019s biological rhythms. Such an approach represents a promising, cost-effective frontier to further personalize the therapeutic journey and optimize long-term outcomes in resectable NSCLC<\/jats:p>","DOI":"10.1177\/03008916261454505","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T09:51:58Z","timestamp":1782813118000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Beyond the calendar: A narrative review on chronobiological drivers of prognosis in resectable NSCLC"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2773-0524","authenticated-orcid":false,"given":"Giovanni","family":"Leuzzi","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Minicozzi","sequence":"additional","affiliation":[{"name":"Unit of Bioinformatics and Biostatistics, Fondazione IRCCS\u2013Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Verderio","sequence":"additional","affiliation":[{"name":"Unit of Bioinformatics and Biostatistics, Fondazione IRCCS\u2013Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lo Russo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Proto","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara Maura","family":"Ciniselli","sequence":"additional","affiliation":[{"name":"Unit of Bioinformatics and Biostatistics, Fondazione IRCCS\u2013Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7037-402X","authenticated-orcid":false,"given":"Alessandro","family":"Pardolesi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsela","family":"Prelaj","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0388-6655","authenticated-orcid":false,"given":"Teresa","family":"Beninato","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Calderoni","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Uslenghi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Solli","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/15347354221096080"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2012.08.007"},{"key":"e_1_3_2_4_2","first-page":"326","article-title":"Circadian rhythms and lung cancer in the context of aging: a review of current evidence","volume":"17","author":"Xu W","year":"2025","unstructured":"Xu W, Li L, Cao Z, et al. 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