Induction Chemotherapy is Not Superior to a Surgery-First Strategy for Clinical N1 Non-Small Cell Lung Cancer

The authors tested the hypothesis that induction therapy improves survival in patients undergoing resection for clinical N1 disease using information from the National Cancer Data Base.  10% of over 5,000 pts were treated with induction therapy.  They were 2:1 propensity matched with patients undergoing the traditional surgery first strategy.  Among surgery first patients, 16% were overstaged (pN0) and 11% were understaged (pN2-3).   There was no difference in short-term outcomes or survival between the two treatment groups.