Evidence map›Paper›PMID 24687416›Full record

SynthesisSurgical endoscopy2014

Management of acute cholecystitis in cancer patients: a comparative effectiveness approach.

Thejus T Jayakrishnan, Ryan T Groeschl, Ben George, James P Thomas, Sam Pappas, T Clark Gamblin, Kiran K Turaga

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 40% 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

2 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Acute Acalculous Cholecystitis in Hospitalized Patients With Hematologic Malignancies and Prognostic Importance of Gallbladder Ultrasound Findings.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2019
    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

7 authors at 2 institutions in 1 country.

Thejus T JayakrishnanDivision of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI, 53226, USA, tjayakri@mcw.edu.
Ryan T Groeschl
Ben George
James P Thomas
Sam Pappas
T Clark Gamblin
Kiran K Turaga
Medical College of Wisconsin · USLoyola University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHost factors and therapy characteristics predispose cancer patients to a high risk of acute cholecystitis. Management of cholecystitis is often difficult given complex decision making involving the underlying cancer, possible interruption of treatment, and surgical fitness of the patient.

methodsA management pathway was developed for cholecystitis in cancer patients which incorporated patient-specific survival and risks of recurrence. Estimates were obtained from a multistage systematic review. A decision tree with a lifetime horizon was constructed to compare conventional strategies [conservative treatment (CT), percutaneous cholecystostomy (PC) and definitive cholecystectomy (DC)] with the new pathway (NP). The decision tree was optimized for highest estimated survival. Sensitivity analyses were performed.

resultsIn low surgical risk patients with cancer-specific survival of 12 months, the NP yielded estimated survivals of 11.9 versus 11.8 (CT) versus 11.8 (PC) versus 11.9 months for the DC arm. For high-risk patients, the estimated survival was 11.6 (NP), 9.9 (DC), 11.4 (PC), and 11 (CT) months, respectively. The decision to perform a DC at 6 weeks after a PC was optimum in patients expected to survive 24 months (23.2 months from the NP) or with a shorter expected survival but a high recurrence risk (>20 %). Model estimates were robust in sensitivity analyses.

conclusionsIncorporation of the surgical risk and the risk of recurrent cholecystitis, while balancing the patient-specific survival and the impact of antineoplastic therapy in the management of cholecystitis yields improved survival. This work provides measures to evaluate surgical judgment, and can augment the physician-patient decision making.

Indexed as

Disease ManagementCholecystectomyCholecystitis, AcuteCholecystostomyHumansNeoplasms

Identifiers

PMID24687416
OpenAlexW1982103717

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.