Evidence map›Paper›PMID 40521963›Full record

ArticleThoracic cancer2025

Optimizing Pre-Operative Clinical Staging in Resectable Non-Small Cell Lung Cancer (NSCLC): A Retrospective Cohort Study.

E Samuel, C Thomas, C Thompson, E Paul, M Cherk, S Ellis, M Siemienowicz, S Tissera, U Samankula, S Scholz and 11 more

Abstract read
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Article in Thoracic cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

21 authors.

E SamuelSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.ORCID https://orcid.org/0000-0003-3165-8756
C ThomasDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
C ThompsonDepartment of Radiology, Alfred Health, Melbourne, Australia.
E PaulSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
M CherkMonash University, Melbourne, Australia.
S EllisDepartment of Radiology, Alfred Health, Melbourne, Australia.
M SiemienowiczDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
S TisseraSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.ORCID https://orcid.org/0009-0007-7712-9362
U SamankulaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
S ScholzDepartment of Medicine, Alfred Health, Melbourne, Australia.
L ZhangMonash University, Melbourne, Australia.
J GrewalMonash University, Melbourne, Australia.
J CoxMonash University, Melbourne, Australia.
C YuDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
G AdabiDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
D KeatingDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
J TavernerDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
J GooiDepartment of Cardiothoracic Surgery, Alfred Health, Melbourne, Australia.
S WayneDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.
J ZalcbergDepartment of Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia.
R G StirlingDepartment of Respiratory Medicine, Alfred Health, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate pre-operative clinical staging is essential for guiding treatment in resectable non-small cell lung cancer (NSCLC). Discrepancies between clinical and pathological staging raise concerns about treatment appropriateness. This study aimed to assess staging accuracy, identify predictors of discordance, and evaluate survival implications.

methodsWe conducted a retrospective cohort study of Stage I-IIIA NSCLC patients who underwent surgical resection in Melbourne, Australia, between 2011 and 2020. Clinical staging was based on CT, PET, and nodal evaluation; pathological staging was based on surgical histology. The primary outcome was concordance between clinical (cTN) and pathological (pTN) stage. Multivariable logistic and Cox regression models evaluated predictors of discordance and survival.

resultsAmong 221 patients, 58% had concordant clinical and pathological staging. Discordance occurred in 42% of cases-23.9% were upstaged and 17.2% downstaged. N-stage concordance was associated with female sex, tumor histology, SUV max, and CT-to-surgery interval. Nodal discordance independently predicted worse survival (HR 0.43, 95% CI: 0.24-0.77; p = 0.01).

conclusionsSubstantial discrepancies exist between clinical and pathological staging in resectable NSCLC. Nodal stage discordance is an independent predictor of mortality and highlights the need for improved pre-operative staging strategies to ensure guideline-concordant care.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasm StagingPrognosisRetrospective StudiesdiscordancemigrationNSCLCquality indicatorsrisk predictionstage concordance

Identifiers

PMID40521963
PMCPMC12168232

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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.