Evidence map›Paper›PMID 28646258›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2018

Selective survival advantage associated with primary tumor resection for metastatic gastric cancer in a Western population.

René Warschkow, Matthias Baechtold, Kenneth Leung, Bruno M Schmied, Daniel P Nussbaum, Beat Gloor, Dan G Blazer Iii, Mathias Worni

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 9% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Pooled it
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  7. The clinical significance for primary tumor surgery in metastatic head and neck adenoid cystic carcinoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023
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  11. Treatment response after palliative radiotherapy for bleeding gastric cancer: a multicenter prospective observational study (JROSG 17-3).Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2022
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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

8 authors at 3 institutions in 2 countries.

René WarschkowDepartment of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
Matthias BaechtoldDepartment of Visceral and Transplantation Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Kenneth LeungDepartment of Surgery, Duke University Medical Center, Duke University, Durham, NC, USA.
Bruno M SchmiedDepartment of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
Daniel P NussbaumDepartment of Surgery, Duke University Medical Center, Duke University, Durham, NC, USA.
Beat GloorDepartment of Visceral and Transplantation Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland.
Dan G Blazer IiiDepartment of Surgery, Duke University Medical Center, Duke University, Durham, NC, USA.
Mathias WorniDepartment of Visceral and Transplantation Surgery, Inselspital, Bern University Hospital, University of Bern, 3010, Bern, Switzerland. mathias.worni@insel.ch.ORCID http://orcid.org/0000-0001-9422-431X
Duke Medical Center · USUniversity of Bern · CHKantonsspital St. Gallen · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prognosis of metastatic gastric cancer (GC) remains dismal, with a median survival of 10 months. Historically, primary tumor resection was not thought to confer any survival benefit. Although high-level data exist guiding treatment of metastatic GC for patients in the East, no such data exist for Western patients despite inherent ethnic differences in GC biology.

methodsThe 2006-2012 National Cancer Database was queried for adult patients with metastatic gastric adenocarcinoma. Patients were classified into those who underwent primary tumor resection and chemotherapy (PTRaC) and those who received chemotherapy only. Groups were propensity score matched, and survival was compared using advanced statistical modeling.

resultsA total of 7026 patients met the inclusion criteria: 6129 (87%) patients were treated with chemotherapy alone and 897 (13%) patients were treated with PTRaC. After multivariable adjustment, patients who underwent PTRaC had a significantly better overall survival (OS) than patients who received systemic therapy only (HR, 0.60; 95% CI, 0.56-0.64; p < 0.001). Following full bipartite propensity score-adjusted analysis, 2-year OS for patients who received chemotherapy only was 12.6% (95% CI, 11.7-13.5%), whereas it was 34.2% (95% CI, 31.3-37.5%) for patients who underwent PTRaC (HR for resection: 0.52; 95% CI, 0.47-0.57; p < 0.001).

conclusionOur data suggest that there exists a subset of patients with metastatic GC for which PTRaC may improve OS. As significant uncertainty still remains, our results support the need for further prospective trials investigating the influence of palliative gastrectomy on survival among Western patients.

Indexed as

AdenocarcinomaAdultAgedAntineoplastic AgentsCombined Modality TherapyFemaleGastrectomyHumansMaleMiddle AgedPalliative CarePrognosisPropensity ScoreRetrospective StudiesStomach NeoplasmsSurvival AnalysisAntineoplastic AgentsGastric cancerMetastaticOverall survivalPalliative gastrectomyPrimary tumor resection

Identifiers

PMID28646258
OpenAlexW2662650857

What OpenQuestion holds

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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.