Surgery vs. SBRT in retrospective analyses: confounding by operability is the elephant in the room

Anatomic lobar resection is the standard of care for medically operable patients with early-stage non-small cell lung cancer (NSCLC), while stereotactic body radiotherapy (SBRT) is preferred among patients deemed medically inoperable and those who wish to avoid surgery (1). The role of SBRT in the medically operable setting has emerged as an area of active research and debate in the thoracic oncology community in recent years. Several randomized trials comparing SBRT and surgery have been launched but subsequently closed early due to poor accrual.