Comments on “Effect of Surgical Treatment for N2-Positive c-Stage III Non–Small Cell Lung Carcinoma in the “PACIFIC” Era”

We read the recent article by Adachi et al 1 Adachi H Ito H Isaka T et al. Effect of surgical treatment for N2-positive c-stage III non-small cell lung carcinoma in the “PACIFIC” era. Clinical Lung Cancer. 2023; Abstract Full Text Full Text PDF Scopus (0) Google Scholar with great interest. The authors should be applauded for aiming to address a critical question in our field – what is the best way to treat patients with locally advanced non-small cell lung cancer (LA-NSCLC)? We agree with their suggestion that patient and disease-specific factors would dictate the optimal treatment pathway for an individual patient. However, we do not believe that their findings support the specific conclusions that (1) “surgery remains the mainstay of N2-positive [clinical] stage III NSCLC treatment” and (2) “surgery should be cautiously considered for patients with [clinical] T3/4 disease.”