Evidence map›Paper›PMID 28593306›Full record

ArticleJAMA surgery2017

Comparative Analysis of Tumor Cell Dissemination to the Sentinel Lymph Nodes and to the Bone Marrow in Patients With Nonmetastasized Colon Cancer: A Prospective Multicenter Study.

Benjamin Weixler, Carsten T Viehl, Rene Warschkow, Ulrich Guller, Michaela Ramser, Guido Sauter, Markus Zuber

Registry-linked trialOpen access · bronzeAbstract readComparative StudyMulticenter Study
In one paragraph

Article in JAMA surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00826579 (Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 34% 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.

NCT00826579 phase1 / phase2completednot on this map

Swiss Prospective, Multicenter Study Sentinel Lymph Node Procedure in Colon Cancer

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2000 to 2009Enrolled192ConditionsColonic NeoplasmsArmsSentinel lymph node procedure, Bone marrow aspiration
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. The Value of Sentinel Lymph Node Mapping for the Staging of Node-Negative Colon Cancer: Propensity Score and Mediation Analyses.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021
    Article
  3. 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

7 authors at 4 institutions in 3 countries.

Benjamin WeixlerDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Carsten T ViehlDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Rene WarschkowDepartment of Surgery, Kantonsspital St Gallen, St Gallen, Switzerland.
Ulrich GullerDepartment of Oncology and Hematology, Cantonal Hospital St Gallen, St Gallen, Switzerland.
Michaela RamserDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Guido SauterDepartment of Pathology, University Hospital Basel, Basel, Switzerland.
Markus ZuberDepartment Surgery, Cantonal Hospital Olten, Olten, Switzerland.
University Hospital of Basel · CHHeidelberg University · DEKantonsschule Olten · CHUniversity Hospital of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceSmall nodal tumor infiltrates (SNTI; isolated tumor cells and micrometastases) in sentinel lymph nodes and bone marrow micrometastases (BMM) were independently described as prognostic factors in patients with colon cancer.

objectiveTo examine the association between the occurrence of SNTI and BMM as well as their prognostic relevance. DESIGN, SETTING, AND

participantsThis prospective study was conducted at 3 university-affiliated institutions in Switzerland between May 2000 and December 2006. Statistical analyses were performed in October 2016. A total of 122 patients with stage I to III colon cancer were included. Follow-up time exceeded 6 years, with no patients lost to follow-up.

interventionsBone marrow aspiration from the iliac crests and in vivo sentinel lymph node mapping were performed during open standard oncological resection. Bone marrow aspirates were stained with the pancytokeratin marker A45-B/B3. All sentinel lymph nodes underwent multilevel sectioning and were stained with hematoxylin-eosin and the pancytokeratin marker AE1/AE3. MAIN OUTCOMES AND MEASURES: Association of SNTI in sentinel lymph nodes and BMM in patients with stage I to III colon cancer and the prognostic effect on disease-free survival (DFS) and overall survival (OS).

resultsOf the 122 patients, 63 (51.6%) were female, with a mean (SD) age of 71.2 (11.7) years. Small nodal tumor infiltrates and BMM were found in a total of 21 patients (17.2%) and 46 patients (37.7%), respectively. The occurrence of BMM was not associated with the presence of SNTI by standard correlation (κ, -0.07; 95% CI, -0.29 to 0.14; P = .49) nor by univariate logistic regression analysis (odds ratio, 0.64; 95% CI, 0.22-1.67; P = .37) or multivariate logistic regression analysis (odds ratio, 1.09; 95% CI, 0.34-3.28; P = .88). The presence of SNTI was an independent negative prognostic factor for DFS (hazard ratio [HR], 2.93; 95% CI, 1.24-6.93; P = .02) and OS (HR, 4.04; 95% CI, 1.56-10.45; P = .005), as was BMM (HR, 2.07; 95% CI, 1.06-4.06; P = .04; and HR, 2.68; 95% CI, 1.26-5.70; P = .01; respectively). The combined detection of BMM and SNTI demonstrated the poorest DFS (HR, 6.73; 95% CI, 2.29-19.76; P = .006) and OS (HR, 5.96; 95% CI, 1.66-21.49; P = .03). CONCLUSIONS AND RELEVANCE: This study demonstrates no association between the occurrence of SNTI and BMM in patients with stage I to III colon cancer. However, both SNTI and BMM are independent negative prognostic factors regarding DFS and OS, and the occurrence of both is associated with significantly worse prognosis compared with either one of them.

trial registrationclinicaltrials.gov Identifier: NCT00826579.

Indexed as

AgedBone MarrowColonic NeoplasmsDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm MicrometastasisNeoplasm StagingProspective StudiesSentinel Lymph NodeSurvival Rate

Identifiers

PMID28593306
PMCPMC5710278
OpenAlexW2621702630

What OpenQuestion holds

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Registered trials

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.