Is spread through alveolar spaces, the newly recognized pattern of invasion, a potential game changer in lung adenocarcinoma?

Lung adenocarcinoma, the most common histologic subtype of lung cancer, is detected at an early stage in 25% of cases. With the implementation of the new National Cancer Institute guidelines, which recommend low-dose CT screening of all high-risk smokers, the number of patients diagnosed with early-stage lung adenocarcinoma is expected to increase (1). Despite early detection, mortality from lung cancer continues to be the highest among all malignancies. As small lung nodules are detected more frequently, the role of surgical intervention and management for early-stage lung cancer will be of increasing interest to thoracic surgeons and oncologists.