Evidence map›Paper›PMID 29980977›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019

The Impact of Extent of Liver Resection Among Patients with Neuroendocrine Liver Metastasis: an International Multi-institutional Study.

Jonathan G Sham, Aslam Ejaz, Michele M Gage, Fabio Bagante, Bradley N Reames, Shishir Maithel, George A Poultsides, Todd W Bauer, Ryan C Fields, Matthew J Weiss and 4 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing 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

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Management of Gastrointestinal Neuroendocrine Tumors.Clinical medicine insights. Endocrinology and diabetes · 2019
    Review
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

14 authors.

Jonathan G ShamDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA.
Aslam EjazDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA.
Michele M GageDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA.
Fabio BaganteDivision of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Bradley N ReamesDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA.
Shishir MaithelDepartment of Surgery, Emory University, Atlanta, GA, USA.
George A PoultsidesDepartment of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.
Todd W BauerDepartment of Surgery, University of Virginia, Charlottesville, VA, USA.
Ryan C FieldsDepartment of Surgery, School of Medicine, Washington University, St. Louis, MO, USA.
Matthew J WeissDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA.
Hugo Pinto MarquesDepartment of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
Luca AldrighettiDepartment of Surgery, Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.
Timothy M PawlikDivision of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Jin HeDepartment of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA. jhe11@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiver resection in patients with neuroendocrine liver metastasis (NELM) provides a survival benefit, yet the optimal extent of resection remains unknown. We sought to examine outcomes of patients undergoing non-anatomic (NAR) versus anatomic liver resection (AR) for NELM using a large international cohort of patients.

methodsTwo hundred and fifty-eight patients who underwent curative intent liver resection from January 1990 to December 2016 were identified from eight institutions. Patients were excluded if they underwent concurrent ablation, had extrahepatic disease, underwent a debulking operation, or had mixed anatomic and non-anatomic resections. Overall (OS) and recurrence-free (RFS) survival were compared among patients based on the extent of liver resection (AR vs. NAR).

resultsMost primary tumors were located in the pancreas (n = 117, 45.4%) or the small intestine (n = 65, 25.2%). Liver resection consisted of NAR (n = 126, 48.8%) or AR (n = 132, 51.2%) resection. The overwhelming majority of patients who underwent NAR had an estimated liver involvement of < 50% (NAR 109, 97.3% vs. AR n = 82, 65.6%; P < 0.001). Patients who underwent NAR also had higher rates of primary tumor lymph node metastasis (NAR n = 79, 71.2% vs. AR n = 37, 33.6%; P < 0.001) and microscopically positive margins (R1) (NAR n = 29, 25.7% vs. AR n = 16, 12.5%; P = 0.009). After a median follow-up of 47.7 months, 48 (18.6%) patients died and 37.0% (n = 95) had evidence of disease recurrence. Patients who underwent AR had both longer median OS (not reached) and RFS (not reached) versus patients who underwent NAR (median OS 138.3 months; median RFS 31.3 months) (both P < 0.01). After controlling for patient and disease-related factors, extent of liver resection was independently associated with an increased risk of recurrence (HR 2.39, 95% CI 1.04-5.48; P = 0.04) but not death (HR 1.92, 95% CI 0.40-9.28; P = 0.42).

conclusionNAR was independently associated with a higher incidence of recurrence versus patients who undergo a formal anatomic hepatectomy among patients with NELM.

Indexed as

HepatectomyAdultAgedCohort StudiesFemaleHumansIntestinal NeoplasmsLiver NeoplasmsLymphatic MetastasisMaleMargins of ExcisionMiddle AgedNeoplasm StagingNeuroendocrine TumorsPancreatic NeoplasmsSurvival RateAnatomic resectionHepatectomyNeuroendocrine tumors

Identifiers

PMID29980977

What OpenQuestion holds

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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.