Patients with small peripheral NSCLC will be randomly assigned to either lobectomy or a sublobar resection (wedge resection or segmentectomy). The surgeon will determine if the tumor is the correct size (less than 2cm) during surgery to qualify a patient for this protocol. At that time the information will be entered into the computer program to randomize the patient to a lobectomy or to sublobar resection. Patients will be followed yearly up to 5 years to determine whether disease free survival (DFS) is non-inferior following sublobar resection compared to lobectomy.
An imaging substudy is also embedded in this protocol to compare pre-operative CT or PET scan imaging characteristics with survival rate and rate of tumor recurrence outcomes.
RATIONALE: Wedge resection or segmentectomy may be less invasive types of surgery than lobectomy for non-small cell lung cancer and may have fewer side effects and improve recovery. It is not yet known whether wedge resection or segmentectomy are more effective than lobectomy in treating stage IA non-small cell lung cancer. PURPOSE: This randomized phase III trial is studying different types of surgery to compare how well they work in treating patients with stage IA non-small cell lung cancer.