Evidence map›Paper›PMID 26427374›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2016

A Tale of Two Cities: Reconsidering Adjuvant Radiation in Pancreatic Cancer Care.

Susanna W L de Geus, Lindsay A Bliss, Mariam F Eskander, Sing Chau Ng, Alexander L Vahrmeijer, Anand Mahadevan, Tara S Kent, A James Moser, Mark P Callery, Bert A Bonsing and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Is Neoadjuvant Therapy Sufficient in Resected Pancreatic Cancer Patients? A National Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018
    Article
  4. 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

11 authors.

Susanna W L de GeusSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Lindsay A BlissSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Mariam F EskanderSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Sing Chau NgSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Alexander L VahrmeijerDepartment of Surgery, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands.
Anand MahadevanDepartment of Radiation Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Stoneman 913, Boston, MA, 02215, USA.
Tara S KentSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
A James MoserSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Mark P CallerySurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Bert A BonsingDepartment of Surgery, Leiden University Medical Center, University of Leiden, Leiden, The Netherlands.
Jennifer F TsengSurgical Outcomes Analysis & Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. jftseng@bidmc.harvard.edu.

Funding

Howard Hughes Medical Institute
6 · The paper itself

Abstract

Adjuvant chemotherapy plays a critical role in the treatment of resected pancreatic cancer patients. However, the role of adjuvant radiation remains controversial. This study compares survival between resected pancreatic cancer patients who received adjuvant radiation and no adjuvant radiation. Medical records of patients with pancreatic ductal adenocarcinoma who underwent surgical resection from January 2003 through 2013 at medical centers in Boston and Leiden were retrospectively reviewed. Propensity score matching was used to correct for potential selection bias in the allocation of adjuvant chemoradiation versus chemotherapy alone. Three hundred fifty total patients were identified, of whom 138 (39.4%) received adjuvant radiation. On pathological staging, 245 (70.0%) had positive lymph nodes, and these patients gained a significant survival benefit from adjuvant radiation (hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.56-0.99) in the complete cohort. After propensity score matching, adjuvant radiation lost its prognostic significance in the complete cohort. However, after matching, patients who survived longer than 12 months and had positive lymph nodes (n = 108) demonstrated a significant (log-rank p = 0.04) survival benefit from adjuvant radiation. This study, while non-randomized, suggests that adjuvant radiation may be associated with a survival benefit for resected pancreatic cancer patients in specific situations.

Indexed as

Chemoradiotherapy, AdjuvantPancreatectomyAdultAgedAged, 80 and overCarcinoma, Pancreatic DuctalChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMaleMiddle AgedPancreatic NeoplasmsPropensity ScoreProportional Hazards ModelsRetrospective StudiesAdjuvant chemoradiotherapyAdjuvant radiotherapyPancreatic neoplasmSurvival

Identifiers

PMID26427374

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.