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649, P = 0.382), however, tumor resection was beneficial for the patients who received adjuvant chemotherapy alone (HR 0.322, P 0.001). In the tumor resection group, lobectomy (HR 0.960, P = 0.917) and systematic lymphadenectomy (HR 1.512, P = 0.259) did not show survival benefit for OS. Main tumor and visible pleural nodule resection could improve prognosis in patients with UPD who could not receive adjuvant targeted therapy. Sublobar resection without systematic lymphadenectomy may be the optimal procedure. Main tumor and visib