“We are not saying lung transplant is appropriate for every patient with stage IV lung cancer. We are saying that when the cancer is rigorously proven to be confined to the lungs, when standard therapies have been exhausted, and when the lungs themselves have become the life-limiting organ, transplantation may offer a new path forward.”

Doesn't "stage IV", by definition, mean that the cancer has already spread to other organs, other parts of the body?

Northwestern Medicine study finds lung transplant dramatically improves survival for patients with terminal lung cancer
JAMA study challenges a long-held transplant rule that patients with stage IV lung cancer shouldn’t receive lung transplants

https://news.nm.org/northwestern-medicine-study-finds-lung-transplant-dramatically-improves-survival-for-patients-with-terminal-lung-cancer/