Stereotactic ablative body radiation therapy or surgery for operable early non-small cell lung cancer patients: bound hand and foot to evidence

Surgery is the standard treatment for operable early stage (stage I: T1–T2N0M0) non-small cell lung cancer (NSCLC) patients. Lobectomy, the surgical resection of a single lobe, is generally accepted as the standard procedure, since sublobar resection has not proved to provide equivalent results yet (1). Video-assisted thoracoscopic surgery (VATS) is becoming the gold standard surgical approach compared to open thoracotomy, as there is no difference in outcomes (2,3). Importantly, a systematic lymph node dissection should be performed in all cases to ensure complete resection. The 5-year overall survival (OS) is 47–51% in patients with clinical stage IA–IB, and 58–73% in surgically staged IA–IB patients, respectively (4). The incidence of local recurrence ranged from 7–23% in large surgical retrospective studies (5,6).