A group of urologists in China has lost their 2012 paper in the Journal of Surgical Research because one of the authors was evidently rather naughty.
The article, “Is the impact of the extent of lymphadenectomy in radical prostatectomy related to the disease risk? A single center prospective study,” purported to show that:
Controversy exists regarding the extent of pelvic lymph node dissection (PLND) in radical prostatectomy (RP) for prostate cancer. Impact of the extent of PLND may be determined by the disease risk. The aim of our study was to find the association between the extent of PLND on biochemical progression and disease risk. METHODS: The study included 360 consecutive patients treated with RP for clinically localized prostate cancer at our department between 2000 and 2003. Patients were randomized to receive extended PLND (n = 180) and standard PLND (n = 180) at RP. Clinical and pathological data were prospectively collected. The patients did not receive any neoadjuvant or adjuvant therapy. The relation of disease risk and the extent of PLND to biochemical progression-free survival (BPFS) were examined. RESULTS: There were no significant differences in age, prostate-specific antigen, and other preoperative features in patients who underwent standard and extended PLND. Mean patient age was 68 y old and median follow-up was 74 mo. BPFS for the standard PLND group and the extended PLND group was 90.1% and 91.3% in low risk disease (log rank P = 0.807), 73.1% and 85.7% in intermediate risk disease (log rank P = 0.042), and 51.1% and 71.4% in high risk disease (log rank P = 0.036), respectively. In multivariate Cox proportional hazard analysis, extended PLND was an independent prognostic factor of biochemical progression-free survival when adjusting for other clinical and pathologic features. CONCLUSIONS: In intermediate and high risk patients, extended PLND positively affects BPFS. In low risk patients, extended PLND may be omitted to reduce operation time and complications.
But according to the retraction notice:
This article has been retracted at the request of the Editors and certain of the co-authors, due to academic misconduct and data falsification on the part of one of the authors, Jindong Ji.
In case anyone needs a reminder, here’s a good example of how these sorts of academic misdeeds can affect patients. The Ji article, which has been cited 27 times, according to Google Scholar, was one of a few cited in this 2014 article in BMJ on prostatectomy:
What should also not be discounted are the improvements in surgical technique that has taken place during this time, including the use of extended pelvic lymphadenectomy in men with intermediate- and high-risk prostate cancer, which has been shown in a randomised controlled trial to improve the cancer-specific survival of men in these risk groups at 7 years following surgery by 12.6% and 20.3%, respectively [4].
Reference 4? That would be
4. Ji J, Yuan H, Wang L, Hou J. Is the impact of the extent of lymphadenectomy in radical prostatectomy related to the disease risk? A single center prospective study. J Surg Res 2012; 178: 779-788.
Let’s not be mean. It is not always straightforward for scientists citing a paper to tell if it was randomized or not. Sometimes even its own authors get confused.[http://www.ncbi.nlm.nih.gov/pubmed/23830344]
Nor should we assume that confusion is harmful. It seems to make treatment more efficacious. [http://www.bmj.com/content/348/bmj.g2688]
The retraction is only modestly important, as it takes the shelf with other retractions based on misconduct. What the key point is, is what exactly is happening to the references that are citing flawed or retracted papers that are built on sand? As I have indicated before, I think the publisher and the authors (maybe the former needs to guide and enforce the latter) are fully responsible to go to the 27 downstream references and at least contact the journal editors and publishers and request an erratum or corrigendum to reflect that this reference (No. [4] in the BMJ reference) no longer exists in the literature, i.e., is retracted. This then also puts the onus on BMJ and the other 26 journals / publishers, to correct their literature. Retractions are not the end point, only the beginning and I have yet to see more than a handful of papers that correct the reference list after a retraction. Are there any clear cases where all citation literature has corrected its reference list following a retraction?