Neoadjuvant Chemotherapy vs Chemoradiation Therapy Followed by Sleeve Resection for Resectable Lung Cancer

Confounding adjustment in observational studies on cardiothoracic interventions: a systematic review of methodological practice

“…The motivation for the method of choice was noted in 3 studies (3%). These stated ‘ As anticipated, the balanced nature of the baseline features in the 2 groups motivates our decision not to perform multivariable adjusted analyses ’ [ 11 ], ‘ Owing to the small sample size and that the 2 groups were later found to be largely similar at baseline, we elected to use weighting rather than matching ’ [ 12 ], and ‘ Maximum likelihood binary logistic regression was unable to be used due to low event rates. Therefore, exact logistic regression was used ’ [ 13 ].…”

Letter re: Neoadjuvant chemoradiotherapy is superior to chemotherapy alone in surgically treated stage III/N2 non-small-cell lung cancer: a retrospective single-center cohort study

“…As a randomized, multicenter, phase III trial, the WJTOG9903 study 2 has shown that induction treatment with concurrent chemoradiotherapy conferred better local control than that in induction chemotherapy, without compromising safety, consequently prolonging the survival in patients with stage IIIA (N2) NSCLC. Several studies based on data from the National Cancer Database suggested that neoadjuvant chemoradiation therapy was associated with increased mortality without an overall survival benefit, 3 and pneumonectomy for clinical stage IIIA NSCLC patients receiving neoadjuvant chemoradiotherapy could not improve survival. 4 We believed that different studies shared different backgrounds.…”

With a Grain of Salt

“…Phase II trials established the current standard of care of neoadjuvant chemoradiotherapy followed by surgical resection for superior sulcus tumors and current guidelines support the role for neoadjuvant treatment for patients with stage IIIA disease, including those with non-bulky N2 involvement [2]. The role for immunotherapy, including in the neoadjuvant treatment continues to grow and will likely become a durable member of the treatment armamentarium for lung cancer [3].Jaradeh and colleagues queried the National Cancer Database to investigate the specific niche question of optimal neoadjuvant treatment for patients who subsequently had bronchial sleeve resections for primary lung cancers [4]. Importantly, these retrospective data demonstrated no difference in long-term survival between patients receiving neoadjuvant chemoradiotherapy compared to those receiving chemotherapy alone.…”

“…Jaradeh and colleagues queried the National Cancer Database to investigate the specific niche question of optimal neoadjuvant treatment for patients who subsequently had bronchial sleeve resections for primary lung cancers [4]. Importantly, these retrospective data demonstrated no difference in long-term survival between patients receiving neoadjuvant chemoradiotherapy compared to those receiving chemotherapy alone.…”