Trial reportWorld journal of surgery2011
Predicting distant metastasis in patients with suspected pancreatic and periampullary tumors for selective use of staging laparoscopy.
Trial report in World journal of surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Diagnostic accuracy of staging laparoscopy for detecting metastasized or locally advanced perihilar cholangiocarcinoma: a systematic review and meta-analysis.Surgical endoscopy · 2016Pooled it
- The Difficulty of Detecting Occult Metastases in Patients with Potentially Resectable Pancreatic Cancer: Development and External Validation of a Preoperative Prediction Model.Journal of clinical medicine · 2024Article
- Predictive Values of Preoperative Markers for Resectable Pancreatic Body and Tail Cancer Determined by MDCT to Detect Occult Metastases.World journal of surgery · 2021Article
- A nomogram of preoperative predictors for occult metastasis in patients with PDAC during laparoscopic exploration.Gland surgery · 2021Article
- Predictors of distant metastasis on exploration in patients with potentially resectable pancreatic cancer.BMC gastroenterology · 2018Article
- Indications for staging laparoscopy in pancreatic cancer.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2016Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with pancreatic or periampullary tumor, staging laparoscopy (SL) can detect metastases that are occult on computed tomography (CT), thereby precluding nontherapeutic laparotomy. Routine SL is not advocated, but some studies suggest its selective use. The aim of this study was to identify patients at risk for metastasis in whom SL could be beneficial.
methodsA consecutive series of patients who underwent laparotomy for a suspected pancreatic or periampullary tumor were analyzed. We included patients with a suspected resectable solid lesion and a recent high-quality CT scan. Patients with and without an intraoperatively encountered metastasis were compared. Regression analysis was performed to examine the association between various predictors and metastasis.
resultsData from 385 patients (mean age 63, 41% women) were analyzed. Distant metastasis was encountered in 79 patients (21%). Logistic regression analysis revealed the following key predictors for metastasis: tumor size on CT scan [odds ratio (OR) 1.43, 95% confidence interval (CI) 1.16-1.76 per millimeter increase], weight loss (OR 1.28, 95% CI 1.01-1.63 per doubling the kilograms), and history of jaundice (OR 2.36, 95% CI 0.79-7.06). In patients with a tumor ≥3 cm and severe weight loss (≥10 kg) and in patients with a tumor ≥4 cm and moderate weight loss (≥5 kg), the proportion of patients with metastasis was >40%.
conclusionsIn patients with a suspected pancreatic or periampullary tumor, the tumor size, weight loss, and jaundice are key predictors of metastasis at exploration. SL might be beneficial in patients with a tumor ≥3 cm and severe weight loss and in those with a tumor ≥4 cm and moderate weight loss.
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