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  • The impact of effective systemic therapies on surgery for stage IV melanoma

    2018, European Journal of Cancer
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    Series of metastasectomy are at the risk of conferring a spurious survival benefit favouring the treatment group, with specific biases such as the immortal time bias; one of the manifestations may be the fact that a patient needs to be alive to be operated on, which may be why the treatment is associated with survival, rather than a real surgical benefit [27]. The lack of comprehensive control groups in most surgical series means that these series may be subject to Aberg's challenge—that patients more likely to live longer regardless of any intervention, are more likely to be selected for surgery; hence it is the process of selection itself, rather than the effect of surgery, that confers an apparent survival benefit [28–30]. Therefore, series such as ours need to be interpreted in that context and with appropriate caution.

  • Evidence-Based and Personalized Medicine. It's [AND] not [OR]

    2017, Annals of Thoracic Surgery
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    There can be no intention-to-treat analysis (Table 1). Welcoming the registry as “the major scientific initiative during the last 20 years” Åberg commented at the time that the “inclusion in the registry of the probably few patients who abstain from operation after being advised to have it would add to the value of the registry” [25]. That would have provided the critical missing piece of information: the unoperated survival for patients who are similar to those having metastasectomy.

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    2016, Surgical Clinics of North America
  • Results of Pulmonary Resection: Sarcoma and Germ Cell Tumors

    2016, Thoracic Surgery Clinics
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    They proposed that improved patient survival was a result of patient selection and not an effect of metastatectomy. Aberg and coworkers published similar views previously.33,34 The authors emphasize the need for randomized trials to determine the true, and not the perceived, effect of pulmonary metastatectomy.

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