Herth et al1 have reemphasized the superiority of endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) in staging non-small cell lung cancer in comparison to CT and positron emission tomography and pushed the boundary to stage I patients. In this group of patients, under general anesthesia, complete mediastinal and hilar node screening was performed with biopsy of lymph nodes (mean, 1.6 per patient) between 5 mm and 10 mm (mean, 7.9 ± 0.7 mm). In reference to their previous report,2 the authors comment that “there is no known difference in yield or patient tolerance if the procedure is performed under moderate sedation or general anesthesia.” However, the patient population studied in this previous report is different. These were patients with adenopathy not limited by size (mean size of lymph nodes sampled, 16 ± 3.6 mm; range, 8 to 32 mm), complete mediastinal and hilar lymph node screening was not performed, and fewer nodes were sampled (mean, 1.14 per patient). These three differences would lead to reduced time and increased simplicity of the procedure, making it more amenable to moderate sedation.