Evidence map›Paper›PMID 29067584›Full record

ArticleSurgical endoscopy2018

Impact of surgical approach on perioperative and long-term outcomes following esophagectomy for esophageal cancer.

Negar Ahmadi, Agnes Crnic, Andrew J Seely, Sudhir R Sundaresan, P James Villeneuve, Donna E Maziak, Farid M Shamji, Sebastien Gilbert

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.5field-weighted citation impact, top 17% 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

7 citing papers in PubMed, 23 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

8 authors at 2 institutions in 1 country.

Negar AhmadiDepartment of General Surgery, University of Ottawa, Ottawa, Canada.ORCID 0000-0003-1468-926X
Agnes CrnicFaculty of Medicine, University of Ottawa, Ottawa, Canada.
Andrew J SeelyDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Sudhir R SundaresanDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
P James VilleneuveDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Donna E MaziakDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Farid M ShamjiDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Sebastien GilbertDivision of Thoracic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada. sgilbert@toh.ca.
University of Ottawa · CAOttawa Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical resection remains a critical component of esophageal cancer treatment with curative-intent. The aim of this study was to compare open (OE) to minimally invasive Ivor Lewis esophagectomy (MIE) with respect to perioperative and oncologic outcomes.

methodsRetrospective single-institution review of MIE and OE patients operated between 2001 and 2015 was conducted. Univariable and multivariable models were created using Cox regression. The Kaplan-Meier method was used to compare oncologic outcomes. Propensity score matching was used to compare oncological outcomes in MIE and OE patients.

resultsOf 210 esophageal resection patients, 47% had OE (137/291) and 25% had MIE (73/291). The MIE and OE groups were comparable with respect to patient factors and operative details. Fewer OE patients received neoadjuvant chemoradiation. MIE was associated with improved lymph node yield, (MIE = 30 [IQR:22-39]; OE = 14 [IQR:7-19], p < 0.001), less intraoperative blood loss (MIE = 312 mL [100-400]; OE = 657 mL [350-700], p < 0.001), and shorter median length of stay (MIE = 10 days [IQR = 8-14]; OE = 14 days [IQR = 11-22] p < 0.01). The OE group had significantly more adverse events resulting in reoperation or intensive care unit admission (MIE = 21%; OE = 34%; p < 0.01). On multivariable analysis, age and positive resection margins were associated with decreased odds of survival. The number of lymph nodes retrieved, positive resection margins, and pathologic stage were significant predictors of disease-free survival. Analysis of 69 matched pairs showed equivalent median overall survival (MIE = 49 months [18-67]; OE = 29 months [17-69]; p = 0.26) and disease-free survival (MIE = 9 [6-22]; OE = 13 [6-22]; p = 0.45) between the two groups.

conclusionsAlthough long-term oncologic outcomes appear to be similar, MIE is associated with significantly less intraoperative blood loss, improved lymph node yield, less risk of severe postoperative adverse events, and shorter length of stay.

Indexed as

Neoplasm StagingPropensity ScoreAgedCanadaCarcinoma, Squamous CellDisease-Free SurvivalEsophageal NeoplasmsEsophagectomyFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedMinimally Invasive Surgical ProceduresPostoperative ComplicationsEsophageal cancerEsophagectomyMinimally invasive surgeryPostoperative adverse eventsSurvival

Identifiers

PMID29067584
OpenAlexW2766256500

What OpenQuestion holds

Textmetadata
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.