Let’s first understand what is stage I (early stage) non-small cell lung cancer (NSCLC)? Stage I (early stage) NSCLC is divided into stage IA and stage IB. According to the 8th edition of AJCC staging, stage IA means T1N0M0, T1 means tumor tumor maximum diameter ≤3cm. stage IB means T2aN0M0, T2a means tumor maximum diameter >3cm, ≤4cm; or tumor size <3cm, but with any of the following conditions: involvement of the main bronchus but not the talar ridge; involvement of the dirty pleura; accompanied by partial or total pneumonia, pulmonary atelectasis. n0 is the absence of lymph node metastasis, and M0 is the absence of distant organ metastasis. The standard treatment for early-stage NSCLC is lobectomy (minimally invasive/conventional) plus mediastinal lymph node dissection. Stereotactic radiation therapy is recommended for patients who cannot tolerate surgery or are unwilling to undergo surgery. Postoperative chemotherapy is not required for stage IA NSCLC. Previous studies have found no benefit of adjuvant chemotherapy in patients with stage IA, therefore, adjuvant chemotherapy is not recommended for patients with stage IA NSCLC after surgery. In addition, most studies of EGFR-TKI as adjuvant targeted therapy have not included patients with stage IA NSCLC, and there is currently no strong evidence-based basis to support the use of adjuvant targeted therapy in patients with EGFR mutation-positive stage IA NSCLC. The ADAURA study, a multicenter randomized clinical trial of adjuvant targeted therapy with oxitinib, showed that the median progression-free survival in the oxitinib group was also significantly better than that in the placebo group (not reached vs. 27.5 months, HR=0.20, p<0.001). The 1-, 2-, and 3-year DFS rates were 97% vs. 69%, 89% vs. 53%, and 79% vs. 41% in the two groups, respectively, with a significant benefit for patients in the axitinib adjuvant group. However, subgroup analysis revealed that the HR in stage IB was only 0.50 compared to 0.12-0.17 in stage II/IIIA (suggesting that close follow-up after surgery for EGFR mutation-positive stage IB NSCLC is also a reasonable option. For patients with EGFR mutation-negative stage IB NSCLC, adjuvant chemotherapy is not routinely recommended after complete tumor resection. For those patients with high-risk factors, a comprehensive multidisciplinary assessment is recommended, and postoperative adjuvant chemotherapy may be considered, taking into account the assessment opinion as well as the patient's general physical condition, routine blood and biochemical status, and wishes. These high-risk factors include: hypodifferentiated tumors (including micropapillary adenocarcinoma and neuroendocrine tumors, but excluding well-differentiated neuroendocrine tumors), visceral pleural invasion, vascular invasion, vascular cancer embolism, and intra-airway dissemination. As for postoperative adjuvant immunotherapy, the IMpower010 study achieved positive results in patients with stage II-IIIA NSCLC with PD-L1TC ≥ 1%, but did not find benefit in stage IB NSCLC, so adjuvant immunotherapy is not recommended for postoperative use in stage IB. What is the stage I survival rate in NSCLC? The 5-year survival rate is commonly used clinically to assess the prognosis of a tumor group at a particular stage. 5-year survival rate is the percentage of patients who survive for more than 5 years after various combination treatments for a certain tumor. If a tumor patient has no signs of recurrence and metastasis at 5 years of follow-up, then it can be assessed as clinical cure. For patients with NSCLC staged as stage IA-IB, the 5-year survival rates reported by the International Association for the Study of Lung Cancer in 2017 were 90% for stage IA1, 85% for stage IA2, 80% for stage IA3, and 73% for stage IB. The length of survival after lung cancer surgery is closely related to several aspects such as whether the surgery is standardized, whether the staging is standardized, whether the postoperative treatment is standardized, the general condition of the patient, the type of postoperative pathology, the degree of differentiation and genetic status.