Evidence map›Paper›PMID 11716884›Full record

Trial reportLancet (London, England)2001

Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial.

J P Neoptolemos, J A Dunn, D D Stocken, J Almond, K Link, H Beger, C Bassi, M Falconi, P Pederzoli, C Dervenis and 8 more

Abstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Lancet (London, England), 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 365 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
365citing papers in PubMed, 10 pooled it
21.5field-weighted citation impact, top 1% 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

365 citing papers in PubMed, 10 syntheses or guidelines pooled it, 1,103 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Extended Versus Standard Lymphadenectomy for Pancreatic Head Cancer: Meta-Analysis of Randomized Controlled Trials.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015
    Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Review
  19. Article
  20. Article

305 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 10 institutions in 7 countries.

J P NeoptolemosDepartment of Surgery, Liverpool University, Liverpool, UK. j.p.neoptplemos@liverpool.ac.uk
J A Dunn
D D Stocken
J Almond
K Link
H Beger
C Bassi
M Falconi
P Pederzoli
C Dervenis
L Fernandez-Cruz
F Lacaine
A Pap
D Spooner
D J Kerr
H Friess
M W Büchler
European Study Group for Pancreatic Cancer
University of Verona · ITUniversity Hospital Ulm · DEUniversity of Bern · CHUniversity of Birmingham · GBUniversity of Liverpool · GBAgia Olga Hospital · GRCancer Research UK Clinical Trials Unit · GBQueen Elizabeth Hospital Birmingham · GBSorbonne Université · FRUniversity of Veterinary Medicine · HU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of adjuvant treatment in pancreatic cancer remains uncertain. The European Study Group for Pancreatic Cancer (ESPAC) assessed the roles of chemoradiotherapy and chemotherapy in a randomised study.

methodsAfter resection, patients were randomly assigned to adjuvant chemoradiotherapy (20 Gy in ten daily fractions over 2 weeks with 500 mg/m(2) fluorouracil intravenously on days 1-3, repeated after 2 weeks) or chemotherapy (intravenous fluorouracil 425 mg/m(2) and folinic acid 20 mg/m(2) daily for 5 days, monthly for 6 months). Clinicians could randomise patients into a two-by-two factorial design (observation, chemoradiotherapy alone, chemotherapy alone, or both) or into one of the main treatment comparisons (chemoradiotherapy versus no chemoradiotherapy or chemotherapy versus no chemotherapy). The primary endpoint was death, and all analyses were by intention to treat. Findings 541 eligible patients with pancreatic ductal adenocarcinoma were randomised: 285 in the two-by-two factorial design (70 chemoradiotherapy, 74 chemotherapy, 72 both, 69 observation); a further 68 patients were randomly assigned chemoradiotherapy or no chemoradiotherapy and 188 chemotherapy or no chemotherapy. Median follow-up of the 227 (42%) patients still alive was 10 months (range 0-62). Overall results showed no benefit for adjuvant chemoradiotherapy (median survival 15.5 months in 175 patients with chemoradiotherapy vs 16.1 months in 178 patients without; hazard ratio 1.18 [95% CI 0.90-1.55], p=0.24). There was evidence of a survival benefit for adjuvant chemotherapy (median survival 19.7 months in 238 patients with chemotherapy vs 14.0 months in 235 patients without; hazard ratio 0.66 [0.52-0.83], p=0.0005). Interpretation This study showed no survival benefit for adjuvant chemoradiotherapy but revealed a potential benefit for adjuvant chemotherapy, justifying further randomised controlled trials of adjuvant chemotherapy in pancreatic cancer.

Indexed as

AdenocarcinomaAgedAntimetabolites, AntineoplasticChemotherapy, AdjuvantCombined Modality TherapyFemaleFluorouracilHumansMaleMiddle AgedPancreatic NeoplasmsQuality of LifeAntimetabolites, AntineoplasticFluorouracil

Identifiers

PMID11716884
OpenAlexW2117954462

What OpenQuestion 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 OpenQuestion graph.