Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Endosonography With or Without Confirmatory Mediastinoscopy for Resectable Lung Cancer: A Randomized Clinical Trial.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled 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.
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
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Rates of Nodal Upstaging following Systematic Endobronchial Ultrasound Lymph Node Staging in Non-Metastatic Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.Respiration; international review of thoracic diseases · 2026Pooled it
- Advanced Bronchoscopic Approaches to Peripheral Pulmonary Lesions: a Narrative Review of Current and Emerging Techniques.Pulmonary therapy · 2026Review
- Review
- Nodal upstaging and neoadjuvant therapy in lung adenocarcinoma: Evidence of a missed opportunity?JTCVS open · 2026Article
- Review
- Recent Updates on Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration and Its Clinical Implications.Tuberculosis and respiratory diseases · 2026Review
- Contemporary Lung Cancer Nodal Staging and Therapeutic Decision-Making in the 9th TNM Era.Cancers · 2026Review
- Patient-reported outcomes in cancer survivorship: insights from two decades of population-based PROFILES registry research.Journal of cancer survivorship : research and practice · 2026Review
- Article
- Rethinking Invasive Mediastinal Staging in the Era of Neoadjuvant Immune-Checkpoint Inhibitors.Thoracic cancer · 2026Review
- Di̇agnosti̇c yi̇eld of EBUS i̇n medi̇asti̇nal stagi̇ng of extrapulmonary mali̇gnanci̇es; si̇ngle center cli̇ni̇cal experi̇ence.BMC pulmonary medicine · 2026Article
- Multidisciplinary international expert consensus recommendations on tissue acquisition in non-small cell lung cancer.EBioMedicine · 2026Article
- Current advances in mediastinal staging for non-small cell lung cancer: a narrative review.Translational lung cancer research · 2026Review
- Neoadjuvant chemoimmunotherapy in non-small cell lung cancer: evolving resectability criteria, biomarker-driven postoperative management, and emerging therapeutic strategies.Journal for immunotherapy of cancer · 2026Review
- Optimizing Lymph Node Staging in Non-Small Cell Lung Cancer Surgery: Evidence, Guidelines, and Quality Improvement Strategies.Journal of clinical medicine · 2026Review
- Balancing Accuracy, Safety, and Cost in Mediastinal Diagnostics: A Systematic Review of EBUS and Mediastinoscopy in NSCLC.Healthcare (Basel, Switzerland) · 2025Review
- Feasibility of intraoperative indocyanine green injection to identify lymph nodes at risk of metastatic disease for early-stage lung cancer.JTCVS techniques · 2025Article
- Compared with assessment via endoscopic examination, assessment through the examination of resected regional lymph nodes can significantly reduce the mortality rate of lung cancer patients: a retrospective study of 222,563 participants from the SEER database.Journal of thoracic disease · 2025Article
- Lymph nodes metastatic burden as a prognosticator for advanced non-small cell lung cancer: a real-world study.Journal of thoracic disease · 2025Article
- Endoscopic Ultrasound as a Diagnostic Tool for the Mediastinum and Thorax.Journal of clinical medicine · 2025Review
Corrections and comments
- Commented on by
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeResectable non-small-cell lung cancer (NSCLC) with a high probability of mediastinal nodal involvement requires mediastinal staging by endosonography and, in the absence of nodal metastases, confirmatory mediastinoscopy according to current guidelines. However, randomized data regarding immediate lung tumor resection after systematic endosonography versus additional confirmatory mediastinoscopy before resection are lacking.
methodsPatients with (suspected) resectable NSCLC and an indication for mediastinal staging after negative systematic endosonography were randomly assigned to immediate lung tumor resection or confirmatory mediastinoscopy followed by tumor resection. The primary outcome in this noninferiority trial (noninferiority margin of 8% that previously showed to not compromise survival,
resultsBetween July 17, 2017, and October 5, 2020, 360 patients were randomly assigned, 178 to immediate lung tumor resection (seven dropouts) and 182 to confirmatory mediastinoscopy first (seven dropouts before and six after mediastinoscopy). Mediastinoscopy detected metastases in 8.0% (14/175; 95% CI, 4.8 to 13.0) of patients. Unforeseen N2 rate after immediate resection (8.8%) was noninferior compared with mediastinoscopy first (7.7%) in both intention-to-treat (Δ, 1.03%; UL 95% CIΔ, 7.2%;
conclusionOn the basis of our chosen noninferiority margin in the rate of unforeseen N2, confirmatory mediastinoscopy after negative systematic endosonography can be omitted in patients with resectable NSCLC and an indication for mediastinal staging.
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.