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.