Evidence map›Paper›PMID 23999923›Full record

SynthesisThe Cochrane database of systematic reviews2013

Post-surgical chemotherapy versus surgery alone for resectable gastric cancer.

Rafael Diaz-Nieto, Rafael Orti-Rodríguez, Marc Winslet

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 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

29 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Laparoscopic versus open gastrectomy for gastric cancer.The Cochrane database of systematic reviews · 2016
    Pooled it
  2. Pooled it
  3. Trial
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  6. Review
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  11. Review
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  15. Comparative effectiveness of adjuvant treatments for resected gastric cancer: a network meta-analysis.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2018
    Article
  16. Article
  17. Article
  18. Article
  19. Increasing survival gap between young and elderly gastric cancer patients.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2017
    Article
  20. 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

3 authors.

Rafael Diaz-NietoHPB Surgery and Liver Transplant Unit, Royal Free Hospital, Pond Street, London, UK, NW3.
Rafael Orti-Rodríguez
Marc Winslet

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor gastric cancer surgery is the mainstay treatment. Chemotherapy seems to improve the survival results. But chemotherapy is not a complication-free therapy and its role has been questioned by some trials.

objectivesTo determine whether post-surgical chemotherapy should be used routinely in resectable gastric cancer. SEARCH

methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded (July 2013). SELECTION CRITERIA: Randomised controlled trials (RCT) comparing post-surgical chemotherapy versus surgery alone for resectable gastric cancer. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion and independently extracted the data. We analysed the data with both the fixed-effect and the random-effects models using the RevMan analysis software. We calculated the hazard ratio (HR) with 95% confidence interval (CI) based on intention-to-treat or available case analysis. MAIN

resultsThe authors identified 34 studies (7824 patients) reporting overall survival (OS) and only 15 reporting disease free survival (DFS) as well. Post-surgical chemotherapy showed an improvement in OS (HR 0.85; 95% CI 0.80 to 0.90) and an improvement in DFS (HR 0.79; 95% CI 0.72 to 0.87), although all the trials had a high risk of bias.The planned analysis of quality of life, return to work, and number of hospital admissions was impossible to complete as the outcome data for the analysis were not available from any trials. AUTHORS'

conclusionsPost-surgical chemotherapy should be used routinely for resectable gastric cancer where possible. Further RCTs are needed to determine the role at each stage of disease.

Indexed as

Antineoplastic AgentsDisease-Free SurvivalFluorouracilGastrectomyHumansLymph Node ExcisionPostoperative CareRandomized Controlled Trials as TopicStomach NeoplasmsAntineoplastic AgentsFluorouracil

Identifiers

PMID23999923
PMCPMC11896092

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.