Evidence map›Paper›PMID 28017812›Full record

ArticleJournal of the American College of Surgeons2017

Distal Cholangiocarcinoma and Pancreas Adenocarcinoma: Are They Really the Same Disease? A 13-Institution Study from the US Extrahepatic Biliary Malignancy Consortium and the Central Pancreas Consortium.

Cecilia G Ethun, Alexandra G Lopez-Aguiar, Timothy M Pawlik, George Poultsides, Kamran Idrees, Ryan C Fields, Sharon M Weber, Clifford Cho, Robert C Martin, Charles R Scoggins and 11 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 8% 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

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  14. Surgical management of biliary malignancy.Current problems in surgery · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 14 institutions in 1 country.

Cecilia G EthunDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Alexandra G Lopez-AguiarDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Timothy M PawlikDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD; Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH.
George PoultsidesDepartment of Surgery, Stanford University, Stanford, CA.
Kamran IdreesDivision of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, TN.
Ryan C FieldsDepartment of Surgery, Washington University, St Louis, MO.
Sharon M WeberDepartment of Surgery, University of Wisconsin, Madison, WI.
Clifford ChoDepartment of Surgery, University of Wisconsin, Madison, WI.
Robert C MartinDivision of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY.
Charles R ScogginsDivision of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY.
Perry ShenDepartment of Surgery, Wake Forest University, Winston-Salem, NC.
Carl SchmidtDivision of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH.
Ioannis HatzarasDepartment of Surgery, New York University, New York, NY.
David BentremDepartment of Surgery, Northwestern University, Chicago, IL.
Syed AhmadDivision of Surgical Oncology, Department of Surgery, University of Cincinnati, Cincinnati, OH.
Daniel AbbottDivision of Surgical Oncology, Department of Surgery, University of Cincinnati, Cincinnati, OH; Department of Surgery, University of Wisconsin, Madison, WI.
Hong Jin KimDivision of Surgical Oncology, Department of Surgery, University of North Carolina, Raleigh, NC.
Nipun MerchantDivision of Surgical Oncology, Department of Surgery, Vanderbilt University, Nashville, TN; Division of Surgical Oncology, Department of Surgery, University of Miami, Miami, FL.
Charles A StaleyDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
David A KoobyDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Shishir K MaithelDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA. Electronic address: smaithe@emory.edu.
Emory University · USUniversity of Wisconsin–Madison · USUniversity of Louisville · USAmerican College of Surgeons · USJohns Hopkins University · USNew York University · USNorthwestern University · USStanford University · USThe Ohio State University · USUniversity of Cincinnati · USUniversity of Miami · USVanderbilt University · USWake Forest University · USWashington University in St. Louis · US

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
NCI NIH HHS K12 CA090625
6 · The paper itself

Abstract

backgroundDistal cholangiocarcinoma (DC) and pancreatic ductal adenocarcinoma (PDAC) are often managed as 1 entity, yet direct comparisons are lacking. Our aim was to use 2 large multi-institutional databases to assess treatment, pathologic, and survival differences between these diseases. STUDY

designThis study included patients with DC and PDAC who underwent curative-intent pancreaticoduodenectomy from 2000 to 2015 at 13 institutions comprising the US Extrahepatic Biliary Malignancy and Central Pancreas Consortiums. Primary endpoint was disease-specific survival (DSS).

resultsOf 1,463 patients, 224 (15%) had DC and 1,239 (85%) had PDAC. Compared with PDAC, DC patients were less likely to be margin-positive (19% vs 25%; p = 0.005), lymph node (LN)-positive (55% vs 69%; p < 0.001), and receive adjuvant therapy (57% vs 71%; p < 0.001). Of DC patients treated with adjuvant therapy, 62% got gemcitabine alone and 16% got gemcitabine/cisplatin. Distal cholangiocarcinoma was associated with improved median DSS (40 months) compared with PDAC (22 months; p < 0.001), which persisted on multivariable analysis (hazard ratio 0.65; 95% CI 0.50 to 0.84; p = 0.001). Lymph node involvement was the only factor independently associated with decreased DSS for both DC and PDAC. The DC/LN-positive patients had similar DSS as PDAC/LN-negative patients (p = 0.74). Adjuvant therapy (chemotherapy ± radiation) was associated with improved median DSS for PDAC/LN-positive patients (21 vs 13 months; p = 0.001), but not for DC patients (38 vs 40 months; p = 0.62), regardless of LN status.

conclusionsDistal cholangiocarcinoma and pancreatic ductal adenocarcinoma are distinct entities. Distal cholangiocarcinoma has a favorable prognosis compared with PDAC, yet current adjuvant therapy regimens are only associated with improved survival in PDAC, not DC. Therefore, treatment paradigms used for PDAC should not be extrapolated to DC, despite similar operative approaches, and novel therapies for DC should be explored.

Indexed as

AdultAgedBile Duct NeoplasmsCarcinoma, Pancreatic DuctalChemoradiotherapy, AdjuvantCholangiocarcinomaCommon Bile Duct NeoplasmsDatabases, FactualDiagnosis, DifferentialFemaleFollow-Up StudiesHumansMaleMiddle AgedPancreatic NeoplasmsPancreaticoduodenectomy

Identifiers

PMID28017812
PMCPMC10191774
OpenAlexW2560931719

What OpenQuestion holds

Textmetadata
LicenceTDM
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.