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0 and 24.5 months, respectively, for upfront surgery. OS was significantly improved with -SM compared with +SM in both groups (p=0.006). When resection yielded +SM, NACRT patients had improved OS compared with upfront surgery patients (p0.001). On multivariable analysis, +SM in the upfront surgery group (hazard ratio [HR] 2.94, 95% confidence interval [CI] 2.04-4.24; p0.001) and older age (HR 1.01, 95% CI 1.00-1.03, per year; p=0.007) predicted worse OS. +SM in the NACRT group was not associated with worse OS (HR 1.09, 95% CI