Evidence map›Paper›PMID 25352267›Full record

Trial reportAnnals of surgical oncology2015

Neoadjuvant therapy is associated with a reduced lymph node ratio in patients with potentially resectable pancreatic cancer.

Christina L Roland, Anthony D Yang, Matthew H G Katz, Deyali Chatterjee, Huamin Wang, Heather Lin, Jean N Vauthey, Peter W Pisters, Gauri R Varadhachary, Robert A Wolff and 3 more

Registry-linked trialAbstract readClinical TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04855331 (Laparoscopic Versus Open Pancreatoduodenectomy Following Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer), which is not on this map. Cited by 64 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 8 pooled it
4.0field-weighted citation impact, top 5% 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.

NCT04855331 naunknown statusnot on this mapstarted 2021, after this paper: background citation

Laparoscopic Versus Open Pancreatoduodenectomy Following Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer: An Multicenter Open-label Randomized Clinical Trial

TypeinterventionalSponsorFudan UniversityRan2021 to 2025Enrolled120ConditionsBorderline Resectable Pancreatic CancerArmsLaparoscopic pancreatoduodenectomy, Open pancreatoduodenectomy
3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 8 syntheses or guidelines pooled it, 135 citations in OpenAlex.

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

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

13 authors at 2 institutions in 1 country.

Christina L RolandDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Anthony D Yang
Matthew H G Katz
Deyali Chatterjee
Huamin Wang
Heather Lin
Jean N Vauthey
Peter W Pisters
Gauri R Varadhachary
Robert A Wolff
Christopher H Crane
Jeffrey E Lee
Jason B Fleming
The University of Texas MD Anderson Cancer Center · USUC Davis Health System · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Kathrin Milbury · 1985 to 2026
$290.8M
TRAINING OF ACADEMIC SURGICAL ONCOLOGISTST32CA009599 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Ashley M Holder, Jennifer A. Wargo · 1988 to 2026
$13.2M
NCI NIH HHS P30 CA016672NCI NIH HHS T32 CA009599
6 · The paper itself

Abstract

backgroundThe use of neoadjuvant therapy (NAC) for the treatment of potentially resectable pancreatic cancer remains controversial. In this study, we sought to evaluate cancer-specific endpoints in patients undergoing a NAC versus a surgery-first (SF) approach with specific emphasis on lymph node metastases.

methodsA total of 222 patients who underwent NAC and 85 patients who underwent SF were identified from 1990 to 2008 and compared for cancer-related endpoints. Peripancreatic lymph nodes from 135 neoadjuvant therapy patients were evaluated for histologic tumor regression.

resultsPatients who underwent NAC followed by surgery had improved overall survival and time to local recurrence compared with the SF approach. NAC patients were less likely to have lymph node metastases (p = 0.001), lymphovascular invasion (LVI), and had smaller tumors. On multivariate analysis, lymph node positivity was associated with SF, tumor size, and the presence of LVI. NAC patients with N0 disease had equivalent outcomes to patients with a low-LNR (0.01-0.15), whereas patients with a LNR >0.15 had reduced survival, and time to local and distant recurrence. Ten of 135 (7.4 %) NAC patients had evidence of tumor regression in at least one lymph node.

conclusionsPatients with potentially resectable PDAC selected to undergo NAC had improved survival and longer time to recurrence. Although some of these differences may be related to improvements in multimodality therapy completion rates, tumor regression in lymph node metastases exists and may demonstrate a biologic benefit of NAC compared with a SF approach.

Indexed as

Neoadjuvant TherapyAdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalCombined Modality TherapyFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph NodesMaleMiddle AgedNeoplasm Grading

Identifiers

PMID25352267
PMCPMC5131370
OpenAlexW2003548590

What OpenQuestion holds

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Registered trials

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.