Wedge Resection vs. Lobectomy for Clinical Stage IA Non-Small Cell Lung Cancer with Occult Lymph Node Disease

In this analysis of 5,437 patients with clinical stage IA (cT1 N0) non-small cell lung cancer identified from the National Cancer Database, overall survival in patients pathologically upstaged to pN1 disease was greater after lobectomy (2,808 patients) than after wedge resection (128 patients). There was no difference in survival between wedge resection and lobectomy in patients upstaged to N2 disease. The authors conclude that their results highlight the importance of intraoperative detection of lymph node disease in lobectomy candidates.