Critical appraisal:Rotolo F, Dunant A, Le Chevalier T, Pignon JP, Arriagada R, IALT Collaborative Group 2014

This appraisal has been completed.

Article: Rotolo F, Dunant A, Le Chevalier T, Pignon JP, Arriagada R, IALT Collaborative Group. Adjuvant cisplatin-based chemotherapy in nonsmall-cell lung cancer: new insights into the effect on failure type via a multistate approach. Ann Oncol 2014 Nov;25(11):2162-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25193990.

Assigned to

User:Chris.karapetis

Topic area

Guidelines:Lung cancer/Treatment/Non-small-cell stage I operable

Clinical question

What is the role of chemotherapy after surgery in the treatment of operable stage I NSCLC?

Form: Form:Critical appraisal

Study design: randomised controlled trial
Level of Evidence: II

Section below only relevant for Cancer Council Project Officer

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Critical Appraisal

Article being appraised

Rotolo F, Dunant A, Le Chevalier T, Pignon JP, Arriagada R, IALT Collaborative Group. Adjuvant cisplatin-based chemotherapy in nonsmall-cell lung cancer: new insights into the effect on failure type via a multistate approach. Ann Oncol 2014 Nov;25(11):2162-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25193990.

Applicable clinical question

What is the role of chemotherapy after surgery in the treatment of operable stage I NSCLC?

Key Facts

Study Design

randomised controlled trial

Study aims:

Evaluate long term outcomes including non-cancer events

Number of Patients:

1687

Reported outcome(s):

Local relapse
Non-brain distant relapse
Brain relapse
Non-cancer mortality

Results of outcome(s):

adjuvant vchemotherapy reduced risk of local relapse and non brain distant relapse but not brain relapse
A small increase in late non-cancer mortality was observed

Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias

Low risk of bias

Comments:

Show/Hide Risk of bias assessment

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?

I am reasonably certain that the trial was double-blinded (eg identical placebo, active placebo, double-dummy, no revealing side-effects).

Was the treatment allocation schedule concealed?

Adequately concealed (e.g. central randomisation, numbered or coded bottles, drugs prepared by pharmacy).

Were all randomised participants included in the analysis?

No exclusions or survival analysis used with all subjects included (>95% follow-up for all groups).

The field below is not considered when calculating the risk of bias rating

How was the allocation schedule generated?

Adequate (e.g. random number table, computer random generator, coin tossing, card shuffling)

Size of effect

1	Reason for decision:

Relevance of evidence

1	Additional comments:

Result of appraisal

Included

Completed by

Associate Professor Christos Karapetis