Evidence map›Paper›PMID 29967992›Full record

ArticleSurgical endoscopy2019

Minimally invasive surgery for stage III colon adenocarcinoma is associated with less delay to initiation of adjuvant systemic therapy and improved survival.

Lawrence Lee, Nathalie Wong-Chong, Justin J Kelly, George J Nassif, Matthew R Albert, John R T Monson

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.2field-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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Impact of hospital volume on survival in patients with locally advanced colon cancer - A Dutch population-based study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. The Current Role of Robotics in Colorectal Surgery.Current gastroenterology reports · 2019
    Review
  10. 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

6 authors at 2 institutions in 2 countries.

Lawrence LeeCenter for Colon and Rectal Surgery, Florida Hospital, Orlando, FL, USA. larry.lee@mcgill.ca.
Nathalie Wong-ChongDepartment of Surgery, McGill University Health Centre, Montreal, QC, Canada.
Justin J KellyCenter for Colon and Rectal Surgery, Florida Hospital, Orlando, FL, USA.
George J NassifCenter for Colon and Rectal Surgery, Florida Hospital, Orlando, FL, USA.
Matthew R AlbertCenter for Colon and Rectal Surgery, Florida Hospital, Orlando, FL, USA.
John R T MonsonCenter for Colon and Rectal Surgery, Florida Hospital, Orlando, FL, USA.
AdventHealth Orlando · USMcGill University Health Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive surgery (MIS) may improve surgical recovery and reduce time to adjuvant systemic therapy after colon cancer resection. The objective of this study was to determine the effect of MIS on the initiation of adjuvant systemic therapy and survival in patients with stage III colon cancer.

methodsThe 2010-2014 National Cancer Database was queried for patients with resected stage III colon adenocarcinoma, and divided into MIS, which included laparoscopic and robotic approaches, and open surgery. Propensity-score matching was used to balanced open and MIS groups. The main outcome measures were delayed initiation of adjuvant systemic therapy (defined as > 8 weeks after surgery) and 5-year overall survival (OS). Multiple Cox regression was performed to identify independent predictors for 5-year OS, including an interaction between delayed systemic therapy and MIS, and adjusted for clustering at the hospital level.

resultsThere were 86,680 patients that were included in this study. Overall, 45% (38,713) underwent MIS colectomy, of which 93% underwent laparoscopic and 7% robotic surgery. After matching, 33,183 open patients were balanced to 33,183 MIS patients. Patient, tumor, and facility characteristics were similar in the matched cohort. More patients in the MIS group received adjuvant therapy within 8 weeks of surgery (49% vs. 42%, p < 0.001), and fewer MIS patients did not receive any systemic therapy (30% vs. 35%, p < 0.001). Delayed initiation of systemic therapy > 8 weeks was associated with worse 5-year OS (HR 1.27, 95%CI 1.19-1.36). MIS was independently associated with improved survival (HR 0.92, 95%CI 0.86-0.97). This relationship remained even if 90-day mortality was excluded.

conclusionsMIS approaches are associated with less delay to the initiation of adjuvant systemic therapy and improved survival in patients with stage III colon adenocarcinoma. Surgeons should favor MIS approaches for the treatment of stage III colon adenocarcinoma whenever possible.

Indexed as

Chemotherapy, AdjuvantMinimally Invasive Surgical ProceduresAdenocarcinomaAgedColectomyColonic NeoplasmsCombined Modality TherapyDatabases, FactualFemaleHumansLaparoscopyMaleMiddle AgedPropensity ScoreProportional Hazards ModelsRetrospective StudiesAdjuvant systemic therapyColon cancerLaparoscopyMinimally invasive surgeryRobotics

Identifiers

PMID29967992
OpenAlexW2809955871

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.