Is surgery still the best management option for early stage NSCLC?

Under the formidable thrust of alternative management options for early stage lung cancer, the role of surgery in this disease subset has been questioned. Stereotactic body radiotherapy (SBRT) has been advocated as an ideal substitute for surgery not only in high risk patients or for the ones who refuse surgery but also in lieu of sublobar resection in otherwise fit patients. The therapeutic modalities for early stage NSCLC were compared as to warranting local control, enabling adequate tissue sampling for biomolecular studies, and effecting optimal pathologic staging while saving lung parenchyma. As a result, surgery still remains the best management option for early stage lung cancer in 2014.