Evidence map›Paper›PMID 27384430›Full record

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

Tumor Biology Rather Than Surgical Technique Dictates Prognosis in Colorectal Cancer Liver Metastases.

Georgios Antonios Margonis, Kazunari Sasaki, Yuhree Kim, Mario Samaha, Stefan Buettner, Neda Amini, Efstathios Antoniou, Timothy M Pawlik

Abstract read
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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 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing 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

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

  1. Pooled it
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  5. Article
  6. Article
  7. Review
  8. Article
  9. METACHRONOUS COLORECTAL LIVER METASTASIS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025
    Review
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  11. Article
  12. Review
  13. Article
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  20. Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022
    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

8 authors.

Georgios Antonios MargonisDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kazunari SasakiDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Yuhree KimDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Mario SamahaDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stefan BuettnerDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neda AminiDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Efstathios AntoniouSecond Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece.
Timothy M PawlikDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. tpawlik1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe interplay of tumor biology and surgical margin status after resection for colorectal liver metastasis (CRLM) remains controversial. Consequently, we sought to determine the impact of surgical margin status on overall survival (OS) stratified by KRAS mutational status. MATERIALS AND

methodsFour hundred eighty-five patients with known KRAS mutational status were identified. Clinicopathologic and long-term survival data were collected and assessed.

resultsOn pathology, most patients (n = 380; 78.3 %) had an R0 margin, while 105 (21.7 %) had an R1. Roughly two thirds of tumors were KRAS wild type (wtKRAS) (n = 307, 63.3 %), while 36.7 % (n = 178) had KRAS mutations (mutKRAS). Median and 5-year OS of the entire cohort was 65.8 months and 53.8 %, respectively. An R1 resection was associated with worse 5-year OS compared with R0 (42.4 % vs. 57.1 %; hazard ratio (HR) 1.82, 95 % CI 1.28-2.57; P = 0.001). After controlling for KRAS status, the survival benefit associated with an R0 resection persisted only among patients with wtKRAS tumors (HR 2.16, 95 % CI 1.42-3.30; P < 0.001). In contrast, surgical margin had no impact on OS among patients with mutKRAS tumors (5-year OS R0, 40.7 % vs. R1, 46.7 %; HR 1.34, 95 % CI 0.73-2.48; P = 0.348).

conclusionThe impact of margin status differed by KRAS mutation status. An R0 margin only provided a survival benefit to patients with wtKRAS tumors. Tumor biology and not surgical technique determined prognosis.

Indexed as

HepatectomyAdultColorectal NeoplasmsFemaleHumansLiver NeoplasmsMaleMutationPrognosisProto-Oncogene Proteins p21(ras)Survival AnalysisKRAS protein, humanProto-Oncogene Proteins p21(ras)CRLMKRAS mutationTumor biology

Identifiers

PMID27384430

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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.