Trial reportThe Journal of thoracic and cardiovascular surgery2025
The extent of lymph node dissection is not associated with disease-free survival following lobar or sublobar resection: Results from Cancer and Leukemia Group B 140503 (Alliance).
Trial report in The Journal of thoracic and cardiovascular surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00499330 (A Phase III Randomized Trial of Lobectomy Versus Sublobar Resection for Small), which is not on this map. Cited by 4 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.
A Phase III Randomized Trial of Lobectomy Versus Sublobar Resection for Small (≤ 2 cm) Peripheral Non-Small Cell Lung Cancer
Who cites it
4 citing papers in PubMed.
- National analysis of the incidence and prognostic importance of nodal metastases in atypical lung carcinoid tumors.JTCVS open · 2026Article
- Clinicopathological and Prognostic Disparities in Part-Solid Versus Pure Solid Pulmonary Nodules as Early-Stage Lung Adenocarcinoma.Thoracic cancer · 2026Article
- CALGB 140503 and the shift to sublobar resection for small, peripheral, node-negative NSCLC: historical context, secondary analyses, and next steps.Frontiers in oncology · 2026Review
- Prognostic impact of the lymph node yield on survival in patients with stage I lung adenocarcinoma receiving sublobar resection.Frontiers in molecular biosciences · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectiveThe extent of lymphadenectomy in patients with c-stage I non-small cell lung cancer is controversial. Cancer and Leukemia Group B 140503 (Alliance; NCT00499330) randomized patients with peripheral clinical stage 1A non-small cell lung cancer 2 cm or less to lobar or sublobar resection after frozen-section examination of 2 mediastinal nodes and 1 major hilar node (simple sampling) confirmed the absence of nodal metastases. Additional node dissection was performed at the surgeon's discretion and included simple sampling, systematic sampling, or complete lymph node dissection. We report the impact of the extent of lymphadenectomy on disease- and recurrence-free survival in this trial.
methodsBetween June 2007 and March 2017, 697 patients were randomized to lobar resection (357) or sublobar resection (340). Data on the extent of lymphadenectomy were available on 689 patients: A total of 182 patients had complete lymph node dissection, 349 patients had systematic sampling, and 158 patients had simple sampling. Disease-free survival was defined as the time to lung cancer recurrence or all-cause mortality. Recurrence-free survival was defined as the time to lung cancer recurrence or death from lung cancer. Survival end points were estimated using the Kaplan-Meier method. Stratified Cox proportional hazards models estimated hazard ratios and their CIs.
resultsBaseline characteristics were generally similar between groups. Five-year disease-free survival was 62.3% (95% CI, 55.2-70.4) after complete lymph node dissection, 65.7% (95% CI, 60.7-71.2) after systematic sampling, and 61.2% (95% CI, 53.7-69.7) after simple sampling. Disease-free survival was not statistically significantly different between lobar resection and sublobar resection based on the extent of node dissection. Five-year disease-free survival among patients who had complete lymph node dissection was 65.7% (95% CI, 56.4-76.6) after lobar resection and 58.5% (95% CI, 48.2-71.1) after sublobar resection (P = .530). Five-year disease-free survival in patients who had simple sampling/systematic sampling was 63.5% (95% CI, 57.6-70.0) after lobar resection and 65.1% (95% CI, 59.2-71.6) after sublobar resection. Five-year recurrence-free survival for patients who had complete lymph node dissection was 72.5% (95% CI, 63.5-82.9) after lobar resection and 68.9% (95% CI, 59.0-80.5) after sublobar resection (P = .526). Five-year recurrence-free survival in patients who had simple sampling/systematic sampling was 70.8% (95% CI, 65.0-77.0) after lobar resection and 70.2% (95% CI, 64.4-76.5) after sublobar resection (P = .604). There was no difference between groups in the incidence of systemic recurrence or isolated hilar, mediastinal, or supraclavicular nodal recurrence.
conclusionsIn patients with peripheral c-stage IA non-small cell lung cancer 2 cm or less in size who have no nodal metastases to at least 2 mediastinal nodes and 1 major hilar lymph node, there is no difference in disease-free survival or recurrence-free survival based on the extent of lymph node dissection regardless of the magnitude of parenchymal resection. Our findings apply to a highly selected cohort of patients deemed node negative by meticulous radiographic and intraoperative nodal 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.