Evidence map›Paper›PMID 22511691›Full record

ArticleJAMA2012

Long-term survival following partial vs radical nephrectomy among older patients with early-stage kidney cancer.

Hung-Jui Tan, Edward C Norton, Zaojun Ye, Khaled S Hafez, John L Gore, David C Miller

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 5 pooled it
–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

147 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Article
  8. Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Hung-Jui TanDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI 48109-2800, USA.
Edward C Norton
Zaojun Ye
Khaled S Hafez
John L Gore
David C Miller

Funding

Physician Organization and the Efficiency of Surgical Specialty CareK08HS018346 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MILLER, DAVID C · 2010 to 2013
$620k
Variation in surgical care for early-stage kidney cancerF32CA123819 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MILLER, DAVID C · 2006 to 2006
$58k
AHRQ HHS K08 HS018346AHRQ HHS K08 HS018346-01A1NCI NIH HHS F32 CA123819
6 · The paper itself

Abstract

contextAlthough partial nephrectomy is the preferred treatment for many patients with early-stage kidney cancer, recent clinical trial data, which demonstrate better survival for patients treated with radical nephrectomy, have generated new uncertainty regarding the comparative effectiveness of these treatment options.

objectiveTo compare long-term survival after partial vs radical nephrectomy among a population-based patient cohort whose treatment reflects contemporary surgical practice. DESIGN, SETTING, AND PATIENTS: We performed a retrospective cohort study of Medicare beneficiaries with clinical stage T1a kidney cancer treated with partial or radical nephrectomy from 1992 through 2007. Using an instrumental variable approach to account for measured and unmeasured differences between treatment groups, we fit a 2-stage residual inclusion model to estimate the treatment effect of partial nephrectomy on long-term survival.

main outcome measuresOverall and kidney cancer-specific survival.

resultsAmong 7138 Medicare beneficiaries with early-stage kidney cancer, we identified 1925 patients (27.0%) treated with partial nephrectomy and 5213 patients (73.0%) treated with radical nephrectomy. During a median follow-up of 62 months, 487 (25.3%) and 2164 (41.5%) patients died following partial or radical nephrectomy, respectively. Kidney cancer was the cause of death for 37 patients (1.9%) treated with partial nephrectomy, and 222 patients (4.3%) treated with radical nephrectomy. Patients treated with partial nephrectomy had a significantly lower risk of death (hazard ratio [HR], 0.54; 95% CI, 0.34-0.85). This corresponded with a predicted survival increase with partial nephrectomy of 5.6 (95% CI, 1.9-9.3), 11.8 (95% CI, 3.9-19.7), and 15.5 (95% CI, 5.0-26.0) percentage points at 2, 5, and 8 years posttreatment (P < .001). No difference was noted in kidney cancer-specific survival (HR, 0.82; 95% CI, 0.19-3.49).

conclusionAmong Medicare beneficiaries with early-stage kidney cancer who were candidates for either surgery, treatment with partial rather than radical nephrectomy was associated with improved survival.

Indexed as

AgedAged, 80 and overCause of DeathCohort StudiesFemaleHumansKaplan-Meier EstimateKidney NeoplasmsMaleMedicareNeoplasm StagingNephrectomyRetrospective StudiesRiskSEER ProgramUnited States

Identifiers

PMID22511691
PMCPMC3864575

What OpenQuestion holds

Textmetadata
LicenceTDM
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.