Evidence map›Paper›PMID 26463497›Full record

ArticleSurgical endoscopy2016

Optimal management for patients not meeting the inclusion criteria after endoscopic submucosal dissection for gastric cancer.

Takahiro Toyokawa, Masaichi Ohira, Hiroaki Tanaka, Hiroaki Minamino, Katsunobu Sakurai, Yasuaki Nagami, Naoshi Kubo, Atsushi Yamamoto, Koji Sano, Kazuya Muguruma and 5 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
2.4field-weighted citation impact, top 11% 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

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  3. [Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2020
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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

15 authors at 2 institutions in 1 country.

Takahiro ToyokawaDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Masaichi OhiraDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. masaichi@med.osaka-cu.ac.jp.
Hiroaki TanakaDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Hiroaki MinaminoDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Katsunobu SakuraiDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Yasuaki NagamiDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Naoshi KuboDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Atsushi YamamotoDepartment of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
Koji SanoDepartment of Gastroenterology, Osaka City General Hospital, Osaka, Japan.
Kazuya MugurumaDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Kazunari TominagaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hiroko NebikiDepartment of Gastroenterology, Osaka City General Hospital, Osaka, Japan.
Yoshito YamashitaDepartment of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
Tetsuo ArakawaDepartment of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Kosei HirakawaDepartment of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Osaka City University · JPOsaka City General Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe necessity of additional gastrectomy for patients not meeting the inclusion criteria after endoscopic submu cosal dissection (ESD) is controversial. The aim of this study was to elucidate the risk factors for lymph node metastasis (LNM) and residual cancer (RC) in patients not meeting the inclusion criteria after ESD and to determine additional treatment strategies.

methodsOf 1443 gastric cancer patients who underwent ESD between 2004 and 2013, 167 patients diagnosed as having a lesion not meeting the inclusion criteria after ESD were retrospectively analyzed. Of the 167 cases, 100 cases underwent additional gastrectomy, and 67 cases were observed without surgery.

resultsOverall, 9.0 % (9/100) and 9.0 % (9/100) of patients not meeting the inclusion criteria after ESD presented with LNM and RC, respectively, but neither was observed in 83 patients (83.0 %). Multivariate analysis revealed that lymphovascular involvement (LVI) (OR 38.38; 95 % CI 1.94-761.43, p = 0.017) and undifferentiated type (OR 45.58; 95 % CI 2.88-720.94, p = 0.007) were independent risk factors for LNM, and positive horizontal margin was an independent risk factor for RC (OR 9.48; 95 % CI 1.72-52.13, p = 0.010). In differentiated types without LVI, no cases had LNM (0/38) in the additional gastrectomy group, and there was no lymph node or distant recurrence (0/39) in the observation group.

conclusionsAdditional treatment is necessary for patients with LVI, undifferentiated type, and positive horizontal margin. Careful follow-up may be acceptable for patients with the differentiated type without LVI, especially for the elderly or patients with severe comorbidities.

Indexed as

AdenocarcinomaAgedAged, 80 and overCarcinoma, Signet Ring CellEndoscopic Mucosal ResectionFemaleGastrectomyGastric MucosaGastroscopyHumansLymphatic MetastasisLymph NodesMaleMiddle AgedMultivariate AnalysisNeoplasm Recurrence, LocalEndoscopic submucosal dissectionGastrectomyGastric cancerLymph node metastasisResidual cancerRisk factor

Identifiers

PMID26463497
OpenAlexW1909544420

What OpenQuestion holds

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Read underepoch 390

Registered trials

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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.