Do Stage I Patients Need Systemic Therapy?

Surgery has been the primary treatment modality for patients with stage I non-small cell lung cancer (NSCLC) with limited to no role for adjuvant systemic therapy. However, 10% to 30% of patients with completely resected stage I NSCLC will recur, with higher risk of recurrence in tumors with higher maximum standardized uptake value, lymphovascular invasion, visceral pleural invasion, and International Association for the Study of Lung Cancer grade. Forthcoming trials of targeted therapies and immunotherapies may expand the role of adjuvant systemic therapy for patients with stage I NSCLC in the future.