Evidence map›Paper›PMID 29998009›Full record

ArticleJournal of gastrointestinal oncology2018

Does a fine line exist between regional and metastatic pelvic lymph nodes in rectal cancer-striking discordance between national guidelines and treatment recommendations by US radiation oncologists.

Jehan Belal Yahya, Daniel O Herzig, Matthew Joseph Farrell, Catherine R Degnin, Yiyi Chen, John Holland, Simon Brown, Jerry Jaboin, Vassiliki Liana Tsikitis, Kim Lu and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

12 authors.

Jehan Belal YahyaDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Daniel O HerzigDepartment of Surgery, Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR, USA.
Matthew Joseph FarrellDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Catherine R DegninDepartment of Biostatistics, Oregon Health and Science University Knight Cancer Institute, Portland, OR, USA.
Yiyi ChenDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
John HollandDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Simon BrownDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Jerry JaboinDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Vassiliki Liana TsikitisDepartment of Surgery, Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR, USA.
Kim LuDepartment of Surgery, Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR, USA.
Charles R ThomasDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.
Timur MitinDepartment of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManagement of rectal cancer with involved lateral pelvic lymph nodes (LPLNs) at the time of diagnosis-the stage we refer institutionally to as Stage 3.5-is controversial. The American Joint Committee on Cancer's 7

methodsAmerican ROs completed an anonymous institutional review board-approved online questionnaire regarding rectal cancer management.

resultsAmong the 220 completed responses, 45% treat more than 10 patients annually and 39% work in academia. We found 10.5% and 34.2% recommend biopsy of clinically involved internal and common iliac LNs, respectively. The vast majority of responders-98.6% and 94.5%-treat involved internal and common iliac LNs with curative intent, respectively. Respondents recommend treatment intensification to involved internal iliac LNs by dissection of the nodal basin (88.2%) and radiation therapy (RT) boost (59.1%), and treatment intensification to involved common iliac LNs by LN dissection (76.4%) and RT boost (63.6%).

conclusionsOur analysis reveals that the vast majority of US ROs approach patients with involved LPLNs, both regional (internal iliac) and metastatic (common iliac), with curative intent. They recommend treatment intensification with surgical resection and/or RT boost to involved nodes. Prospective clinical trials need to determine the appropriate management of patients with Stage 3.5 rectal cancer.

Indexed as

guideline adherenceintentionlymph node excisionRadiation oncologyrectal neoplasms

Identifiers

PMID29998009
PMCPMC6006036

What OpenQuestion holds

Textmetadata
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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.