Evidence map›Paper›PMID 24358318›Full record

ArticlePloS one2013

The role of non-curative surgery in incurable, asymptomatic advanced gastric cancer.

Ming-ming He, Dong-sheng Zhang, Feng Wang, Zhi-qiang Wang, Hui-yan Luo, Ying Jin, Xiao-li Wei, Rui-hua Xu

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 3 pooled it
2.1field-weighted citation impact, top 13% 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

23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
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  4. Review
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  11. Surgical management of metastatic gastric cancer: moving beyond the guidelines.Translational gastroenterology and hepatology · 2019
    Review
  12. Intensified neoadjuvant multimodal approach in synchronous liver metastases from gastric cancer: a single institutional experience.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2018
    Review
  13. Selective survival advantage associated with primary tumor resection for metastatic gastric cancer in a Western population.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2018
    Article
  14. Article
  15. Article
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  17. Modest overall survival improvements from 1998 to 2009 in metastatic gastric cancer patients: a population-based SEER analysis.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2016
    Article
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  20. Observational
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

8 authors at 3 institutions in 1 country.

Ming-ming HeState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Dong-sheng ZhangState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Feng WangState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Zhi-qiang WangState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Hui-yan LuoState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Ying JinState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Xiao-li WeiState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Rui-hua XuState Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South ChinaSun Yat-sen University Cancer Center · CNSun Yat-sen University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough general agreement exists on palliative surgery with intent of symptom palliation in advanced gastric cancer (AGC), the role of non-curative surgery for incurable, asymptomatic AGC is hotly debated. We aim to clarify the role of non-curative surgery in patients with incurable, asymptomatic AGC under the first-line chemotherapy.

methodsA total of 737 patients with incurable, asymptomatic advanced gastric adenocarcinoma between January 2008 and May 2012 at the Sun Yat-sen University Cancer Center were retrospectively analyzed, comprising 414 patients with non-curative surgery plus first-line chemotherapy, and 323 patients with first-line chemotherapy only. The clinicopathologic data, survival, and prognosis were evaluated, with propensity score adjustment for selection bias.

resultsThe median overall survival (OS) outcomes significantly favored non-curative surgery group over first-line chemotherapy only group in entire population (28.00 versus 10.37 months, P = 0.000), stage 4 patients (23.87 versus 10.37 months, P = 0.000), young patients (28.70 versus 10.37 months, P = 0.000) and elderly patients (23.07 versus 10.27 months, P = 0.031). The median OS advantages of non-curative surgery over first-line chemotherapy only were also maintained when the analyses were restricted to single organ metastasis (P = 0.001), distant lymph node metastasis (P = 0.002), peritoneal metastasis (P = 0.000), and multi-organ metastasis (P = 0.010). Significant OS advantages of non-curative surgery over chemotherapy only were confirmed solid by multivariate analyses before and after adjustment on propensity score (P = 0.000). Small subsets of patients with surgery of single metastatic lesion after previous curative gastrectomy, and with surgery of both primary and single metastatic sites showed sound median OS.

conclusionsThere is a role for non-curative surgery plus first-line chemotherapy for incurable, asymptomatic AGC, in terms of survival. Randomized controlled trials are warranted to fill a gap in knowledge about the value of metastectomy and patient selection strategies.

Indexed as

Asymptomatic DiseasesPalliative CareAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasm GradingNeoplasm StagingPrognosisStomach NeoplasmsTreatment OutcomeTumor Burden

Identifiers

PMID24358318
PMCPMC3865283
OpenAlexW1986511833

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.