Evidence map›Paper›PMID 37737968›Full record

ArticleAnnals of surgical oncology2024

Fragmentation of Care in Patients with Peritoneal Metastases Undergoing Cytoreductive Surgery.

Mason Vierra, Varun V Bansal, Ryan B Morgan, Hunter D D Witmer, Biren Reddy, Ankit Dhiman, Frederick A Godley, Cecilia T Ong, Erika Belmont, Blasé Polite and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2024. 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
1.9field-weighted citation impact, top 14% 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, 6 citations in OpenAlex.

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

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Mason Vierra *University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Varun V Bansal *Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Ryan B MorganDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Hunter D D WitmerDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Biren ReddyDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Ankit DhimanDepartment of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Frederick A GodleyDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Cecilia T OngDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Erika BelmontDepartment of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL, USA.
Blasé PoliteDepartment of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL, USA.
Ardaman ShergillDepartment of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL, USA.
Kiran K TuragaUniversity of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Oliver S EngDepartment of Surgery, University of California, Irvine, Orange, CA, USA. oeng@hs.uci.edu.ORCID http://orcid.org/0000-0003-0226-5005
University of Chicago Medical Center · USUniversity of Chicago · USAugusta University · USUniversity of California, Irvine · USYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe delivery of multimodal treatment at a high-volume center is known to optimize the outcomes of gastrointestinal malignancies. However, patients undergoing cytoreductive surgery (CRS) for peritoneal metastases often must 'fragment' their surgical and systemic therapeutic care between different institutions. We hypothesized that this adversely affects outcomes. PATIENTS AND

methodsAdults undergoing CRS for colorectal or appendiceal adenocarcinoma at our institution between 2016 and 2022 were identified retrospectively and grouped by care network: 'coordinated care' patients received exclusively in-network systemic therapy, while 'fragmented care' patients received some systemic therapy from outside-network providers. Factors associated with fragmented care were also ascertained. Overall survival (OS) from CRS and systemic therapy-related serious adverse events (SAEs) were compared across the groups.

resultsAmong 85 (80%) patients, 47 (55%) had colorectal primaries and 51 (60%) received fragmented care. Greater travel distance [OR 1.01 (CI 1.00-1.02), p = 0.02] and educational status [OR 1.04 (CI 1.01-1.07), p = 0.01] were associated with receiving fragmented care. OS was comparable between patients who received fragmented and coordinated care in the colorectal [32.5 months versus 40.8 months, HR 0.95 (CI 0.43-2.10), p = 0.89] and appendiceal [31.0 months versus 27.4 months, HR 1.17 (CI 0.37-3.74), p = 0.55] subgroups. The frequency of SAEs (7.8% versus 17.6%, p = 0.19) was also similar.

conclusionsThere were no significant differences in survival or SAEs based on the networks of systemic therapy delivery. This suggests that patients undergoing CRS at a high-volume center may safely receive systemic therapy at outside-network facilities with comparable outcomes.

Indexed as

Appendiceal NeoplasmsColorectal NeoplasmsHyperthermia, InducedPeritoneal NeoplasmsAdultAntineoplastic Combined Chemotherapy ProtocolsCombined Modality TherapyCytoreduction Surgical ProceduresHumansPeritoneumRetrospective StudiesSurvival RateAppendiceal neoplasmsChemotherapyColorectal neoplasmsCytoreductive surgeryHIPEC

Identifiers

PMID37737968
OpenAlexW4386944072

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.