When less is more in thoracic surgery

Abstract

For more than 25 years, a lobectomy rather than a sublobar resection has been regarded the best surgical treatment of early-stage non-small-cell lung cancer (NSCLC) in patients fit for surgery. This recommendation followed the interpretation of the only clinical trial so far (LCSG821), which randomised between the two surgeries and found superior recurrence-free survival.1 LCSG821 has since been criticised because it was performed when the diagnosis of lung cancer was based on simple chest x-rays performed for symptoms.