Evidence map›Paper›PMID 30227129›Full record

ArticleThe Annals of thoracic surgery2019

Multimodality Therapy for N2 Non-Small Cell Lung Cancer: An Evolving Paradigm.

Jonathan D Spicer, Jitesh B Shewale, David B Nelson, Kyle G Mitchell, Matthew J Bott, Eric Vallières, Candice L Wilshire, Ara A Vaporciyan, Stephen G Swisher, David R Jones and 2 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in The Annals of thoracic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 22 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Review
  9. Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 2 countries.

Jonathan D SpicerDivision of Thoracic Surgery, McGill University Health Centre, Montréal, Quebec, Canada. Electronic address: jonathan.spicer@mcgill.ca.
Jitesh B ShewaleDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center (UTHealth) School of Public Health, Houston, Texas.
David B NelsonDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kyle G MitchellDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Matthew J BottThoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
Eric VallièresDivision of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
Candice L WilshireDivision of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
Ara A VaporciyanDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Stephen G SwisherDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
David R JonesThoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
Gail E DarlingDivision of Thoracic Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
Boris SepesiDepartment of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
The University of Texas MD Anderson Cancer Center · USMemorial Sloan Kettering Cancer Center · USMcGill University Health Centre · CAToronto General Hospital · CAUniversity of Texas Health Science Center at Dallas · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

backgroundInduction chemoradiation for resectable N2 non-small cell lung cancer (NSCLC) is used with the intent to optimize locoregional control, whereas induction chemotherapy given in systemic doses is meant to optimally target potential distant disease. However, the optimal preoperative treatment regimen is still unknown and practice patterns continue to vary widely. We compared multiinstitutional oncologic outcomes for N2 NSCLC from 4 experienced lung cancer treatment centers.

methodsThis collaborative retrospective study unites 4 major thoracic oncology centers. Patients with N2 NSCLC undergoing surgical resection after induction chemotherapy (CxT) or concurrent chemoradiation (CxRT) were included. Primary outcomes were overall and disease-free survival (OS and DFS).

results822 patients were identified (CxT = 662 and CxRT = 160). There were no differences in 5-year OS (CxT 39.9% versus CxRT 42.9%, p = 0.250) nor in DFS (CxT 28.7% versus 29.8%, p = 0.207). Recurrence rates (CxT 46.8% versus CxRT 51.6%, p = 0.282) and recurrence patterns were not significantly different (Local: CxT 9.8% versus CxRT 9.7%; and Distant: CxT 30.4% versus CxRT 33.1%, p = 0.764). There was no difference in perioperative mortality. In the analyses of patients who underwent pretreatment invasive mediastinal staging (n = 555), there were still no significant differences in OS (p = 0.341) and DFS (p = 0.455) between the 2 treatment strategies.

conclusionsBoth treatment strategies produce equivalent and better than expected outcomes compared with historical controls for N2 NSCLC, with no differences in recurrence patterns. How these conventional therapeutic strategies will compare with those involving immunotherapy combined with surgical locoregional disease control for N2 disease remains to be determined.

Indexed as

Neoplasm StagingAdultAgedAged, 80 and overAntineoplastic AgentsCarcinoma, Non-Small-Cell LungCombined Modality TherapyDisease-Free SurvivalFemaleFollow-Up StudiesHumansInduction ChemotherapyLung NeoplasmsMaleMiddle AgedNorth AmericaAntineoplastic Agents

Identifiers

PMID30227129
PMCPMC6993842
OpenAlexW2891341014

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.