Evidence map›Paper›PMID 30091108›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2018

Evaluating TNM stage prognostic ability in a population-based cohort of gastric adenocarcinoma patients in a low-incidence country.

Alyson L Mahar, Brandon Zagorski, Daniel Kagedan, Matthew Dixon, Abraham El-Sedfy, Jovanka Vasilevska-Ristovska, Daniela Cortinovis, Corwyn Rowsell, Calvin Law, Lucy Helyer and 2 more

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of public health = Revue canadienne de sante publique, 2018. 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. A prognostic nomogram to predict the cancer-specific survival of patients with initially diagnosed metastatic gastric cancer: a validation study in a Chinese cohort.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025
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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

12 authors.

Alyson L MaharManitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. alyson_mahar@cpe.umanitoba.ca.
Brandon ZagorskiInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Daniel KagedanEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
Matthew DixonEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
Abraham El-SedfyEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
Jovanka Vasilevska-RistovskaHospital for Sick Children, Toronto, ON, Canada.
Daniela CortinovisInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Corwyn RowsellSt. Michael's Hospital, Toronto, ON, Canada.
Calvin LawInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Lucy HelyerDepartment of Surgery, Dalhousie University, Halifax, NS, Canada.
Lawrence PaszatInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Natalie CoburnInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTNM stage is the preeminent cancer staging system and a fundamental determinant of disease prognosis. Our goal was to evaluate the predictive power of TNM stage for gastric adenocarcinoma (GAC), in a low-incidence country.

methodsA province-wide chart review of GAC patients diagnosed from April 1, 2005 to March 31, 2008 was conducted in Ontario and linked to routinely collected vital status data with a follow-up on March 31, 2012. TNM staging was classified using the sixth and seventh Union International for Cancer Control/American Joint Committee on Cancer editions. Kaplan-Meier and log-rank tests compared stage-stratified survival estimates. Discrimination was evaluated using Harrell's C statistic.

resultsThe cohort included 2366 patients. One- and 5-year survival was 43% and 17%. Using the sixth edition, 9% of patients had stage I disease, 5.4% stage II, 7.3% stage III, and 64% stage IV; 15% were not staged. Using the seventh edition, 9% were stage I, 7.7% stage II, 16% stage III, and 54% stage IV; 14% were not staged. Stage-stratified 5-year survival ranged from 68% to 7% with the sixth edition and from 70% to 4% with the seventh edition. Harrell's C statistic was 0.64 (0.63-0.65) for the broad sixth edition staging categories and 0.68 (0.67-0.69) for the broad seventh edition. Discriminative power was similar for the refined stage categories and across multiple subgroup analyses; it was best in non-metastatic patients.

conclusionExisting staging systems for GAC used in North America predict individualized prognosis poorly. The creation of a more complex prediction tool is necessary to provide accurate and precise prognostication information to oncologists, patients, and their families.

Indexed as

AdenocarcinomaAgedCohort StudiesFemaleHumansIncidenceMaleMiddle AgedNeoplasm StagingOntarioPredictive Value of TestsPrognosisStomach NeoplasmsGastric adenocarcinomaPrognosisTNM stage

Identifiers

PMID30091108
PMCPMC6964621

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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.