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.