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<i>Background and Objectives</i><i>:</i> Lobe-specific nodal dissection (L-SND) is currently acceptable for the dissection of early-stage non-small cell lung cancer (NSCLC) but not for cancers of more advanced clinical stages. We aimed to assess the efficacy of L-SND, compared to systemic nodal dissection (SND). <i>Materials and Methods</i>: We retrospectively collected the clinical data of patients with carcinoembryonic antigen (CEA) abnormality who underwent complete resection of NSCLC via lobectomy or more in addition to either SND or L-SND at two cancer-specific institutions from January 2006 to December 2017. <i>Results</i>: A total of 799 patients, including 265 patients who underwent SND and 534 patients who underwent L-SND, were included. On multivariate analysis, thoracotomy, more than lobectomy, cN1-2, advanced pathological stage, adjuvant treatment, and <i>EGFR</i> or <i>ALK</i> were strongly associated with SND. No significant differences were found in overall survival, disease-free survival, and overtime survival after propensity adjustment (<i>p</i> = 0.09, <i>p</i> = 0.11, and <i>p</i> = 0.50, respectively). There were no significant differences in local (<i>p</i> = 0.16), regional (<i>p</i> = 0.72), or distant (<i>p</i> = 0.39) tumor recurrence between the two groups. <i>Conclusions</i>: SND did not improve the prognosis of NSCLC patients with CEA abnormality. Complete pulmonary resection via L-SND seems useful for NSCLC patients with CEA abnormality.