Evidence map›Paper›PMID 27353482›Full record

ArticleThe Annals of thoracic surgery2016

Cancer Recurrence After Esophagectomy: Impact of Postoperative Infection in Propensity-Matched Cohorts.

Vernissia Tam, James D Luketich, Daniel G Winger, Inderpal S Sarkaria, Ryan M Levy, Neil A Christie, Omar Awais, Manisha R Shende, Katie S Nason

Open access · greenAbstract read
In one paragraph

Article in The Annals of thoracic surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.9field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 20 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

9 authors at 1 institution in 1 country.

Vernissia TamDepartment of General Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
James D LuketichDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Daniel G WingerUniversity of Pittsburgh Clinical and Translational Science Institute, Pittsburgh, Pennsylvania.
Inderpal S SarkariaDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Ryan M LevyDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Neil A ChristieDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Omar AwaisDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Manisha R ShendeDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
Katie S NasonDepartment of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: nasonks@upmc.edu.
University of Pittsburgh · US

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
Barriers to Early Detection of Esophageal AdenocarcinomaK07CA151613 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NASON, KATIE S · 2011 to 2015
$818k
NCATS NIH HHS UL1 TR000005NCI NIH HHS K07 CA151613NCI NIH HHS L30 CA179766
6 · The paper itself

Abstract

backgroundPostoperative infection increases cancer recurrence and worsens survival in colorectal cancer, but the relationship for esophagogastric adenocarcinoma after esophagectomy is not well defined. We aimed to determine whether recurrence and survival after minimally invasive esophagectomy for esophagogastric adenocarcinoma were influenced by postoperative infection using propensity-matched analysis.

methodsWe abstracted data for 810 patients (1997-2010) and defined exposure as at least 1 in-hospital or 30-day infectious complication (n = 206 [25%]). Using 29 pretreatment/intraoperative variables, patients were propensity-score matched (caliper = 0.05). Time to cancer recurrence and survival (Kaplan-Meier curves and the Breslow test), and associated factors (Cox regression with shared frailty) were assessed.

resultsAfter propensity matching (n = 167 pairs), median bias across propensity-score variables was reduced from 12.9% (p < 0.001) to 4.4% (p = 1.000). Postoperative infection was not associated with rate (n = 60 versus 63; McNemar p = 0.736) or time to recurrence in those in whom disease recurred (median, 10.7 versus 11.1 months; Wilcoxon signed-rank p = 0.455) but was associated with shorter overall survival (n = 124 versus 102 deaths; median, 26 versus 41 months; Breslow p = 0.002). After adjusting for age, body mass index, neoadjuvant therapy, sex, comorbidity score, positive resection margins, pathologic stage, R0 resection, and recurrence, postoperative infection was associated with a 44% greater hazard for death (hazard ratio, 1.44; 95% confidence interval, 1.10-1.89).

conclusionsIn patients with esophagogastric adenocarcinoma, infections after esophagectomy were not associated with an increased rate or earlier time to recurrence when baseline characteristics associated with infection risk were balanced using propensity-score matching. Despite this, overall survival was shorter in patients with infectious complications. After adjusting for other important survival predictors, infections after esophagectomy continued to be independently associated with worse survival.

Indexed as

Neoplasm StagingAdenocarcinomaAgedEsophageal NeoplasmsEsophagectomyFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedMinimally Invasive Surgical ProceduresNeoplasm Recurrence, LocalPennsylvaniaPropensity ScoreRetrospective Studies

Identifiers

PMID27353482
PMCPMC5436488
OpenAlexW2471664452

What OpenQuestion holds

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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.