Qiuyuan Li, et al. - Researchers queried the National Cancer Database for patients with clinical T4N0-1 non-small-cell lung cancer (NSCLC) (which were historically thought to be curable but now include tumors of size >7 cm in the 8th edition tumor, node and metastasis (TNM) staging) to determine the impact of surgery and predictive factors of long-term survival following surgery in this renewed group of patients. Analysis revealed age, gender, comorbidity, nodal status, resection margin, tumor grade, chemotherapy, and extension-size group as independent predictive factors for survival in these patients. For patients whose treatment included surgery, worse survival in the newly defined T4 NSCLC was more frequently observed in correlation with tumor size >7 cm vs local extension alone. Favorable long-term outcomes are possible for T4-extended, N0–1 NSCLC with a tumor size ≤7 cm in correlation with surgery and should be encouraged as an option for treatment.