Evidence map›Paper›PMID 26968526›Full record

ArticleBMC cancer2016

Urgent surgery after emergency presentation for colorectal cancer has no impact on overall and disease-free survival: a propensity score analysis.

Benjamin Weixler, Rene Warschkow, Michaela Ramser, Raoul Droeser, Urs von Holzen, Daniel Oertli, Christoph Kettelhack

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

Article in BMC cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 2 pooled it
7.7field-weighted citation impact, top 3% 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

37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.

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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

7 authors at 2 institutions in 3 countries.

Benjamin WeixlerDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Rene WarschkowDepartment of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
Michaela RamserDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Raoul DroeserDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Urs von HolzenDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Daniel OertliDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
Christoph KettelhackDepartment of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland. christoph.kettelhack@usb.ch.
University Hospital of Basel · CHZimmer Biomet (Germany) · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt remains a matter of debate whether colorectal cancer resection in an emergency setting negatively impacts on survival. Our objective was therefore to assess the impact of urgent versus elective operation on overall and disease-free survival in patients undergoing resection for colorectal cancer by using propensity score adjusted analysis.

methodsIn a single-center study patients operated for colorectal cancer between 1989 and 2013 were identified from a prospectively maintained database. Median follow-up was 44 months. Patients with neoadjuvant treatment were excluded. The impact of urgent operation on overall and disease-free survival was assessed using both Cox regression and propensity score analyses.

resultsOf 747 patients with colorectal cancer, 84 (11%) had urgent and 663 elective cancer resection. The propensity score revealed strongly biased patient characteristics (0.22 ± 0.16 vs. 0.10 ± 0.09; P < 0.001). In unadjusted analysis urgent operation was associated with a 35% increased risk of overall mortality (hazard ratio(HR) of death = 1.35, 95% confidence interval(CI):1.02-1.78, P = 0.045). In risk-adjusted Cox regression analysis urgent operation was not associated with poor overall (HR = 1.08, 95%CI:0.79-1.48; P = 0.629) or disease-free survival (HR = 1.02, 95%CI:0.76-1.38; P = 0.877). Similarly in propensity score analysis urgent operation did not influence overall (HR = 0.98, 95% CI:0.74-1.29), P = 0.872) and disease-free survival (HR = 0.89, 95%CI:0.68 to 1.16, P = 0.387).

conclusionsThis study provides evidence that worse oncologic outcomes after urgent operation for colorectal cancer are caused by clinical circumstances and not due to the urgent operation itself. Urgent operation is not a risk factor for colorectal cancer resection.

Indexed as

Disease-Free SurvivalPrognosisAdultAgedColorectal NeoplasmsDigestive System Surgical ProceduresFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoadjuvant TherapyPropensity ScoreProportional Hazards ModelsColorectal cancerDisease-free survivalEmergency surgeryOncological outcomeOveral survival

Identifiers

PMID26968526
PMCPMC4787247
OpenAlexW2295585136

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.