SynthesisChest2019
The Accuracy of Clinical Staging of Stage I-IIIa Non-Small Cell Lung Cancer: An Analysis Based on Individual Participant Data.
Synthesis in Chest, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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.
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
36 citing papers in PubMed.
- Whole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies.Health technology assessment (Winchester, England) · 2019Trial
- Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed non-small-cell lung cancer: the prospective Streamline L trial.The Lancet. Respiratory medicine · 2019Trial
- Article
- Leveraging Large Language Models to Integrate Clinical Knowledge and Machine Learning Predictions for Lymph Node Metastasis Prediction: Development of a Knowledge-Augmented Framework.JMIR medical informatics · 2026Article
- Characterizing phantom lymph node collection during curative-intent resection of non-small cell lung cancer.The Journal of thoracic and cardiovascular surgery · 2026Article
- Impact of non-tumor size related features on staging in non-small cell lung cancer: a population-level analysis of the SEER-medicare database.Journal of thoracic disease · 2026Article
- Clinical Versus Pathologic Staging in Early-Stage Non-Small Cell Lung Cancer Assessed by an Established Lung Cancer Multidisciplinary Meeting.Thoracic cancer · 2026Article
- Clinical and economic impact of recurrence in unresected non-small cell lung cancer treated with primary stereotactic body radiotherapy: A real-world study using SEER-Medicare data.Journal of managed care & specialty pharmacy · 2025Article
- Prediction of Lung Cancer Metastasis Using Machine Learning Models Based on Clinical Laboratory Data.Cancer reports (Hoboken, N.J.) · 2025Article
- Robotic versus video-assisted thoracoscopic surgery for pathological stage II-IIIB non-small cell lung cancer: evaluation of perioperative and survival outcomes.Journal of thoracic disease · 2025Article
- Real-Life Pre-Operative Nodal Staging Accuracy in Non-Small Cell Lung Cancer and Its Relationship with Survival.Diagnostics (Basel, Switzerland) · 2025Article
- Unlocking the potential of immunotherapy for patients with resectable non-small cell lung cancer.Frontiers in oncology · 2025Review
- Article
- What Is the Accuracy of Clinical Staging for Stage III-Single-station N2 NSCLC? A Multi-Centre UK Study.JTO clinical and research reports · 2024Article
- A retrospective analysis of treatment patterns, overall survival, and real-world disease-free survival in early-stage non-small cell lung cancer following complete resection.BMC pulmonary medicine · 2024Article
- Defining resectability: When do you try to take it out?JTCVS open · 2024Article
- Clinical and economic outcomes associated with lymph node examination status in early-stage non-small cell lung cancer: a real-world US study using the SEER-Medicare linked database.Translational cancer research · 2024Article
- Minimally invasive surgery for clinical T4 non-small-cell lung cancer: national trends and outcomes.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2024Article
- Factors affecting accuracy of clinical staging in resectable non-small cell lung cancer in a real-world study.Thoracic cancer · 2024Article
- Comparison of radiological and pathological tumor sizes in resected non-small cell lung cancer.General thoracic and cardiovascular surgery · 2023Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on byResponse.2019
Authors and funding
6 authors.
Funding
Abstract
backgroundClinical staging of non-small cell lung cancer (NSCLC) helps determine the prognosis and treatment of patients; few data exist on the accuracy of clinical staging and the impact on treatment and survival of patients. We assessed whether participant or trial characteristics were associated with clinical staging accuracy as well as impact on survival.
methodsWe used individual participant data from randomized controlled trials (RCTs), supplied for a meta-analysis of preoperative chemotherapy (± radiotherapy) vs surgery alone (± radiotherapy) in NSCLC. We assessed agreement between clinical TNM (cTNM) stage at randomization and pathologic TNM (pTNM) stage, for participants in the control group.
resultsResults are based on 698 patients who received surgery alone (± radiotherapy) with data for cTNM and pTNM stage. Forty-six percent of cases were cTNM stage I, 23% were cTNM stage II, and 31% were cTNM stage IIIa. cTNM stage disagreed with pTNM stage in 48% of cases, with 34% clinically understaged and 14% clinically overstaged. Agreement was not associated with age (P = .12), sex (P = .62), histology (P = .82), staging method (P = .32), or year of randomization (P = .98). Poorer survival in understaged patients was explained by the underlying pTNM stage. Clinical staging failed to detect T4 disease in 10% of cases and misclassified nodal disease in 38%.
conclusionsThis study demonstrates suboptimal agreement between clinical and pathologic staging. Discrepancies between clinical and pathologic T and N staging could have led to different treatment decisions in 10% and 38% of cases, respectively. There is therefore a need for further research into improving staging accuracy for patients with stage I-IIIa NSCLC.
Indexed as
Identifiers
What OpenQuestion holds
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.