What is the primary treatment for Stage I and II non-small cell lung cancer?

• A. Immunotherapy only
• B. Palliative care
• C. Observation
• D. Surgical resection

Answer: (D)

For early-stage non-small cell lung cancer, the goal is curative removal of all tumor tissue. If the cancer is localized to the lung (stages I–II) and the patient can tolerate surgery, removing the tumor with a margin of healthy tissue and performing systematic mediastinal lymph node sampling provides the best chance for long-term survival. The typical operation is a lobectomy, often with lymph node dissection, because this approach offers optimal local control and accurate staging. In select small or peripheral tumors, or when lung function limits extensive surgery, limited resections like segmentectomy or wedge resection may be considered, but overall surgical resection remains the standard for curative intent.

Immunotherapy alone, palliative care, and observation are not primary curative strategies for early-stage disease. Immunotherapy can play a role in higher-stage disease or as part of adjuvant therapy in selected cases, while palliative care and observation are appropriate for non-curative settings or other clinical contexts, not for achieving cure in early-stage NSCLC.