The explanation for the development of recurrent disease, especially distant metastases, in patients with completely resected pathologic early-stage lung cancer has eluded physicians for decades. Since 2015, spread of tumor through air spaces, a previously unrecognized phenomenon, has been accepted as a mechanism of tumor recurrence after lung resection.1,2 Surgeons are increasingly familiar with molecular and genetic markers that characterize aggressive lung tumor behavior, which may suggest the need for systemic adjuvant therapy, even in patients with completely resected early-stage cancers.3
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Ferguson MK. Small Modifications in Technique May Yield Large Rewards After Lung Cancer Surgery. JAMA Surg. 2019;154(7):e191014. doi:10.1001/jamasurg.2019.1014
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