Comparison of Different Types of Surgery in Treating Patients With Stage IA Non-Small Cell Lung Cancer

INTERVENTION: Sublobar resection (removal of less than one lobe of lung) consists of either segmentectomy or wedge resection of lung. Segmentectomy refers to identifying and cutting the specific blood supply and airway to the particular segment of the lobe of lung containing the lung cancer. The procedure takes 2‐3 hours. Wedge resection refers to calculating a margin of normal tissue that allows full removal of the cancer, then removing that from the lobe of the lung using a cutting stapler. The procedure takes about one hour. Sublobar resection can be done through a thoracotomy (large cut on the side of the chest) or with Video‐Assisted Thoracic Surgery (VATS), which uses small incisions and a telescope to achieve the same internal operation. CONDITION: Lung Cancer PRIMARY OUTCOME: Disease‐free survival as assessed by chest X‐rays and computed tomography (CT Scan) of the chest. Additional investigations such as positron emission tomography (PET scan) and biopsies will also be used if clinically indicated. SECONDARY OUTCOME: Overall survival as determined by physical examination Pulmonary function as measured by expiratory flow rate Rate of loco‐regional and systemic recurrence as assessed by chest X‐rays and computed tomography (CT Scan) of the chest. Additional investigations such as positron emission tomography (PET scan) and biopsies will also be used if clinically indicated. INCLUSION CRITERIA: Suspected or proven non‐small cell lung cancer (NSCLC), meeting both preoperative and intraoperative criteria: Preoperative criteria ‐ Peripheral lung nodule = 2 cm by computed tomography (CT scan) AND Center of the tumor must be located in the outer third of the lung in either the transverse, coronal, or sagittal plan AND Tumor location must be suitable for either lobar or sublobar resection (wedge resection or segmentectomy) AND No pure ground opacities or pathologically confirmed N1 or N2 disease Intraoperative criteria ‐ Histologically confirmed NSCLC AND Confirmation of N0 status by frozen section examination of nodal levels 4, 7, and 10 on the right side and 5, 6, 7, and 10 on the left side (Levels 4 and 7 nodes may be sampled up to 6 weeks preoperatively by mediastinoscopy, endobronchial ultrasound (EBUS), and/or endoscopic ultrasound (EUS), or at the time of thoracotomy or video‐assisted thoracoscopic surgery (VATS) exploration)