Indication and Planning for Lobar Versus Sublobar Resection

Sublobar resection can be performed in selected patients with early stage nonsmall cell lung cancer with noninferior oncologic outcomes to lobectomy. Resection with surgical margins ≥2 cm or greater than the maximal tumor diameter, as well as station-based lymph node sampling or dissection of at least 3 mediastinal and one intrapulmonary or hilar lymph node, should be performed. Conversion from sublobar resection to lobectomy should be considered in patients with evidence of nodal metastasis on intraoperative frozen sections. In patients found to have occult nodal disease after resection, adjuvant systemic therapy is indicated.