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Discussion

    Published:November 06, 2019DOI:https://doi.org/10.1016/j.jtcvs.2019.09.113
        Dr Robert Meguid (Englewood, Colo). Dr Raman, and to your coauthors, congratulations on your study. Thank you for sending me a copy of the manuscript in the slides in advance. You examined a subset of patients who have the unfortunate pathologic diagnosis or nondiagnosis of an indeterminate margin after resection for Stage I through Stage IIIA non–small cell lung cancer. Fortunately for patients, this is a very small subset. Unfortunately for the analysis, a very small subset limits many of the conclusions. When you breakdown the number of patients who received different treatment modalities with an indeterminate margin status, you are looking at cohorts <100 patients, as you pointed out. I'm sure we've all had this misfortune where pathologists aren't able to give us definitive margin status or worse, change their minds after frozen, intraoperative, or postoperative results giving us post hoc change that may have a positive margin. I think we need to hold the pathologists to the same standards that we are held to in guiding our patient management. I'm sure most of you in the room or all of you agree with that.
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