ArticleThe Journal of thoracic and cardiovascular surgery2017
Biopsy first: Lessons learned from Cancer and Leukemia Group B (CALGB) 140503.
Article in The Journal of thoracic and cardiovascular surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Survival after lobectomy versus sub-lobar resection in elderly with stage I NSCLC: a meta-analysis.BMC surgery · 2019Pooled it
- Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer.The New England journal of medicine · 2023Trial
- Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post-hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503).The Lancet. Respiratory medicine · 2018Trial
- Is sublobar resection equivalent to lobectomy in Black and Hispanic patients with clinical stage IA non-small cell lung cancer?JTCVS open · 2026Article
- Safety and feasibility of bronchoscopic indocyanine green-methylene blue versus CT-guided autologous blood-methylene blue localization for pulmonary nodules: a propensity score-matched analysis.Journal of cardiothoracic surgery · 2026Article
- N1 Staging in Non-Small Cell Lung Cancer: Current Situation, Limitations, and the Importance of Peripheral Nodal Assessment.Cancers · 2026Review
- Occult Node Detection With Lobectomy Versus Segmentectomy for Stage IA NSCLC.JTO clinical and research reports · 2025Article
- A clinical nomogram for predicting occult lymph node metastasis in patients with non-small-cell lung cancer ≤2 cm.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Review
- Smart Sensors and Microtechnologies in the Precision Medicine Approach against Lung Cancer.Pharmaceuticals (Basel, Switzerland) · 2023Review
- An optimal thoracoscopic segmentectomy approach: Combined ultra-high-definition 4K endovision systems with "no-waiting" technique in S8-9 complex segmentectomy.Thoracic cancer · 2023Article
- Knowing the Bad: Adverse Event-Informed, High-Risk, Early-Stage Non-Small Cell Lung Cancer Treatment Options.Annals of the American Thoracic Society · 2022Article
- Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?Journal of thoracic disease · 2021Article
- Significance of preoperative biopsy in radiological solid-dominant clinical stage I non-small-cell lung cancer.Interactive cardiovascular and thoracic surgery · 2021Article
- Comparative Effectiveness of Lobectomy, Segmentectomy, and Wedge Resection for Pathological Stage I Non-small Cell Lung Cancer in Elderly Patients: A Population-Based Study.Frontiers in surgery · 2021Article
- Use of Robotics in Surgical Treatment of Non-small Cell Lung Cancer.Current treatment options in oncology · 2020Review
- Preoperative biopsy and tumor recurrence of stage I adenocarcinoma of the lung.Surgery today · 2020Article
- Are segmentectomy and lobectomy comparable in terms of curative intent for early stage non-small cell lung cancer?General thoracic and cardiovascular surgery · 2020Review
- Conditional survival analysis of four treatment strategies for patients with stage I non-small cell lung cancer.Oncology letters · 2019Article
- Node-Positive Segmentectomy for Non-Small-Cell Lung Cancer: Risk Factors and Outcomes.Clinical lung cancer · 2019Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveCancer and Leukemia Group B 140503 is an ongoing, multicenter randomized trial assessing whether sublobar resection is equivalent to lobectomy for the treatment of stage I A non-small cell lung cancer (NSCLC) ≤2 cm in diameter. The objective of this report is to determine the reasons precluding intraoperative randomization.
methodsFrom June 15, 2007, to March 22, 2013, 637 patients were preregistered to the trial. Three hundred eighty-nine were randomized successfully (61%), and 248 patients were not randomized (39%). We analyzed the reasons for nonrandomization among a subset of the nonrandomized patients (208) for whom additional data were available.
resultsOf these 208 patients, undiagnosed benign nodules (n =104, 16% of all registered patients) and understaging of NSCLC (n =45, 7% of all registered patients) were the dominant reasons precluding randomization. Granulomas represent one-quarter of the benign nodules. The understaged patients had unsuspected nodal metastases (n =28) or other more advanced NSCLC. The rate of randomization was significantly greater in those patients who had a preoperative biopsy (P <.001).
conclusionsIn a carefully monitored cohort of patients with suspected small NSCLC ≤2 cm, a substantial number are misdiagnosed (benign nodules) or understaged. These patients may not have benefited from a thoracic surgical procedure. Preoperative biopsy significantly increased the rate of correct diagnosis. Preoperative biopsy of small suspected NSCLC will reduce the number of nontherapeutic or unnecessary thoracic procedures. Accuracy in preoperative diagnosis is increasingly important as more such small nodules are discovered through lung cancer screening.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.