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Dr RobertMeguid(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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