Chemotherapy plus Surgery versus Surgery Alone in Non-Small-Cell Lung Cancer

To the Editor: We are concerned about several aspects of the study by Rosell et al. (Jan. 20 issue) 1 . The title is incorrect and misleading: the trial did not compare preoperative chemotherapy plus surgery with surgery alone; the trial compared preoperative chemotherapy plus surgery plus radiotherapy with surgery plus radiotherapy. The rates of survival and disease-free survival were extremely poor in the surgery-plus-radiotherapy group. These rates would be expected among patients with metastatic non-small-cell lung cancer but are inferior to what would be expected in patients with resectable stage III disease. In several randomized trials, reviewed by Van Houtte, . . .