Talcott WJ, Miccio JA, Park HS, et al. - Given carcinoma in situ represents a rare non-invasive histology of non-small cell lung cancer (NSCLC) with excellent survival results with resection, but there is lack of clarity about management of lung biopsy suggestive of in situ disease, thus, researchers herein assessed the rate of invasive disease presence upon resection of lesions with an initial biopsy suggestive of purely in situ disease. Participants were 951 patients suffering from NSCLC, identified from the National Cancer Database, whose workup incorporated a lung biopsy suggestive of in situ disease. The rate of invasive disease identified on surgical pathology along with significant demographic as well as clinical contributors to invasion risk were investigated in the cohort who proceeded to resection. Findings showed the presence of invasive disease at resection in about half of patients with biopsy suggestive of in situ disease. The identified strong predictors of invasive disease included tumor size and histology, and these may be used for risk stratification. However, the practice of definitive therapy, whenever feasible, is supported by the results.