Evidence map›Paper›PMID 40398369›Full record

ArticleSurgery2025

Patterns of care in patients with asymptomatic stage IV colon cancer: A population-based analysis.

Lauren Weaver, Catherine G Tran, Amanda R Kahl, Alexander Troester, Aditi Mishra, Ajay Prakash, David Brauer, Mary E Charlton, Imran Hassan, Paolo Goffredo

Abstract read
In one paragraph

Article in Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

10 authors.

Lauren WeaverDivision of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN. Electronic address: https://twitter.com/LWeaver_MD.
Catherine G TranDepartment of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA.
Amanda R KahlDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
Alexander TroesterDivision of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN.
Aditi MishraDepartment of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA.
Ajay PrakashDivision of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN.
David BrauerDivision of Surgical Oncology, Department of Surgery, University of Minnesota, Minneapolis, MN.
Mary E CharltonDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
Imran HassanDepartment of Surgery, University of Iowa Hospitals & Clinics, Iowa City, IA.
Paolo GoffredoDivision of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN. Electronic address: goffr002@umn.edu.

Funding

NCI NIH HHS HHSN261201800012CNCI NIH HHS HHSN261201800012I
6 · The paper itself

Abstract

backgroundCurrents guidelines recommend chemotherapy with or without biologic agents for asymptomatic stage IV colon cancer treatment, whereas primary tumor resection is reserved for symptomatic tumors or resectable metastases. However, US treatment patterns are understudied. Our study aims to identify real-world treatment patterns for asymptomatic metastatic colon cancer.

methodsAdults with asymptomatic metastatic colon cancer were identified in the 2014 Surveillance, Epidemiology, and End Results Patterns of Care database and categorized into 6 groups: chemotherapy with or without biologic agents, chemotherapy with or without biologic agents with primary tumor resection and metastasectomy, chemotherapy with or without biologic agents and primary tumor resection alone, primary tumor resection only, no treatment, or other treatments. Multinomial logistic regression was used to examine factors associated with receiving each treatment modality. Cox proportional hazard models were used to assess the relationships between treatments and survival.

resultsAmong 1,717 weighted patient cases, 28% received chemotherapy with or without biologic agents, 23% chemotherapy with or without biologic agents with primary tumor resection, 12% chemotherapy with or without biologic agents with primary tumor resection and metastasectomy, 12% primary tumor resection only, 23% no treatment, and 2% other treatment. Younger patients were more likely to receive chemotherapy with or without biologic agents with primary tumor resection and metastasectomy than chemotherapy with or without biologic agents alone (odds ratio, 3.32; 95% confidence interval, 1.3-8.6) and less likely to undergo no treatment (odds ratio, 0.05; 95% confidence interval, 0.02-0.17). Patients treated by chemotherapy with or without biologic agents with primary tumor resection and metastasectomy had the greatest median survival of 61 months, whereas those with no treatment had a 1-month median survival.

conclusionAlmost one quarter of patients with asymptomatic stage IV colon cancer received no treatment. Meanwhile, 12% of patients underwent curative systemic and surgical treatment, which was associated with a median survival of 5 years, validating reported outcomes of this approach by institutional studies. These data provide an important benchmark for future interventions pertaining to asymptomatic patients with stage IV colon cancer.

Indexed as

Asymptomatic DiseasesColonic NeoplasmsPractice Patterns, Physicians'AdultAgedAged, 80 and overColectomyFemaleHumansMaleMetastasectomyMiddle AgedNeoplasm StagingRetrospective StudiesSEER ProgramUnited States

Identifiers

PMID40398369
PMCPMC12335924

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Registered trials

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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.