Evidence map›Paper›PMID 29632424›Full record

ArticleWorld journal of gastroenterology2018

Impact of postoperative TNM stages after neoadjuvant therapy on prognosis of adenocarcinoma of the gastro-oesophageal junction tumours.

Michael Thomaschewski, Richard Hummel, Ekaterina Petrova, Juliana Knief, Ulrich Friedrich Wellner, Tobias Keck, Dirk Bausch

Abstract readComparative StudyValidation Study
In one paragraph

Article in World journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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.

Michael ThomaschewskiDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany. michael.thomaschewski@uksh.de.
Richard HummelDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.
Ekaterina PetrovaDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.
Juliana KniefDepartment of Pathology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.
Ulrich Friedrich WellnerDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.
Tobias KeckDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.
Dirk BauschDepartment of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck 23538, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo compare prognostic relevance of postoperative tumour/node/metastasis (TMN) stages between patients with and without neoadjuvant treatment.

methodsData from patients with adenocarcinoma of the gastro-oesophageal junction (AEG) who had undergone surgical resection at a single German university centre were retrospectively analysed. Patients with or without neoadjuvant preoperative treatment were selected by exact matching based on preoperative staging. Standard assessment of preoperative (c)TNM stage was based on endoscopic ultrasound and computed tomography of the thorax and abdomen, according to the American Joint Committee on Cancer/Union for International Cancer Control classification system. Patients with cT1cN0cM0 and cT2cN0cM0 stages were excluded from the study, as these patients are generally not recommended for pretreatment. Long-term survival among the various postoperative TNM stages was compared between the groups of patients with or without neoadjuvant treatment. For statistical assessments, a P-value of ≤ 0.05 was considered significant.

resultsThe study included a total of 174 patients. The group of patients who had received preoperative neoadjuvant treatment included more cases of AEG (Siewert) type 1 carcinoma (P < 0.001), and consequently oesophagectomy was performed more frequently among these patients (P < 0.001). The two groups (with or without preoperative neoadjuvant treatment) had comparable preoperative T stages, but the group of patients with preoperative neoadjuvant treatment presented a higher rate of preoperative N-positive disease (P = 0.020). Overall long-term survival was not different between the two groups of patients according to tumours of different AEG classifications, receipt of oesophagectomy or gastrectomy, nor between patients with similar postoperative TNM stage, resection margin and grading. However, an improvement of long-term survival was found for patients with nodal down-staging after neoadjuvant therapy (P = 0.053).

conclusionThe prognostic relevance of postoperative TNM stages is similar for AEG in patients with or without neoadjuvant preoperative treatment, but treatment-related nodal down-staging prognosticates longer-term survival.

Indexed as

AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsEndosonographyEsophageal NeoplasmsEsophagectomyEsophagogastric JunctionFemaleGastrectomyGermanyHumansLymphatic MetastasisLymph NodesMaleMiddle AgedNeoadjuvant TherapyNeoplasm StagingAdenocarcinoma of the gastro-oesophageal junctionAmerican Joint Committee on Cancer/Union for International Cancer ControlNeoadjuvant therapyOesophageal cancerTNM system

Identifiers

PMID29632424
PMCPMC5889823

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