Evidence map›Paper›PMID 36854990›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023

Higher Numbers of Examined Lymph Nodes Are Associated with Increased Survival in Resected, Treatment-Naïve, Node-Positive Esophageal, Gastric, Pancreatic, and Colon Cancers.

Razmik Ghukasyan, Sudeep Banerjee, Christopher Childers, Amanda Labora, Daniel McClintick, Mark Girgis, Patrick Varley, Amanda Dann, Timothy Donahue

Abstract read
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In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Razmik Ghukasyan *Department of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Sudeep Banerjee *Department of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Christopher ChildersDepartment of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Amanda LaboraDepartment of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Daniel McClintickDavid Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Mark GirgisDepartment of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Patrick VarleyDepartment of Surgery, University of Wisconsin School of Medicine, Madison, WI, USA.
Amanda DannDepartment of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
Timothy DonahueDepartment of Surgery, David Geffen School of Medicine, University of California, 54-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA. TDonahue@mednet.ucla.edu.ORCID 0000-0002-1175-2545
University of California, Los Angeles · USBrigham and Women's Hospital · USCleveland Clinic · USMemorial Sloan Kettering Cancer Center · USThe University of Texas MD Anderson Cancer Center · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background or purposeThe role of extended lymphadenectomy as part of resection for lymph node (LN)-positive gastrointestinal (GI) malignancies remains controversial with no clear clinical guidance. The purpose of this retrospective study is to determine whether the number of LNs examined as part of GI malignancy resections affects overall survival (OS) among patients with node-positive esophageal, gastric, pancreatic, and colon cancers.

methodsParticipants with LN-positive GI cancers who were diagnosed between 2004 and 2015 and underwent oncologic resections were selected from National Cancer Database (NCDB). The primary predictor was the number of examined LNs categorized in tertiles. The effect on OS was measured by hazard ratio (HR) derived from multivariate Cox regression analyses.

resultsFrom 2004 to 2015, 1877, 10,086, 18,193, and 102,500 patients with LN-positive esophageal, gastric, pancreatic, and colon adenocarcinomas who did not receive neoadjuvant treatment and underwent oncologic tumor resection were registered in the NCDB. Using multivariate Cox proportional hazard modeling, greater LNs examined in surgically resected LN-positive GI cancers were found to be associated with increased OS for all histologies. This association was the strongest (as compared to the lowest tertile) for gastric cancer (middle tertile: HR = 0.91, 95% CI, 0.86-0.96, p = 0.001; highest tertile: HR = 0.73, 95% CI, 0.69-0.78, p < 0.001), followed by colon (highest tertile: HR = 0.86, 95% CI, 0.84-0.88, p < 0.001), esophageal (highest tertile: HR = 0.83, 95% CI, 0.72-0.95, p = 0.01), and pancreatic (highest tertile: HR = 0.93, 95% CI, 0.89-0.98, p = 0.002) cancers. DISCUSSION AND

conclusionIn patients with surgically resected node-positive GI malignancies who did not receive neoadjuvant systemic therapy, a higher number of examined LNs is associated with increased OS. This association is the strongest for gastric cancer, followed by colon, esophageal, and pancreatic cancers respectively.

Indexed as

Colonic NeoplasmsStomach NeoplasmsHumansLymph Node ExcisionLymph NodesNeoplasm StagingPrognosisRetrospective StudiesCancerColonEsophageal cancerGastric cancerLymphadenectomyPancreatic cancer

Identifiers

PMID36854990
OpenAlexW4322625903

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.