Evidence map›Paper›PMID 30151267›Full record

ArticleJournal of gastrointestinal oncology2018

Role of lymph node ratio in selection of adjuvant treatment (chemotherapy

Brice Jabo, Matthew J Selleck, John W Morgan, Sharon S Lum, Khaled Bahjri, Mayada Aljehani, Carlos A Garberoglio, Mark E Reeves, Jukes P Namm, Naveenraj L Solomon and 3 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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. 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

13 authors.

Brice JaboSchool of Public Health, Loma Linda University, Loma Linda, CA, USA.
Matthew J SelleckDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
John W MorganSchool of Public Health, Loma Linda University, Loma Linda, CA, USA.
Sharon S LumDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Khaled BahjriSchool of Public Health, Loma Linda University, Loma Linda, CA, USA.
Mayada AljehaniSchool of Public Health, Loma Linda University, Loma Linda, CA, USA.
Carlos A GarberoglioDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Mark E ReevesDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Jukes P NammDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Naveenraj L SolomonDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Fabrizio LucaDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.
Gary YangDepartment of Radiation Medicine, Loma Linda University, Loma Linda, CA, USA.
Maheswari SenthilDivision of Surgical Oncology, Loma Linda University, Loma Linda, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent randomized controlled trials have failed to show a survival difference between adjuvant chemotherapy (CT) and adjuvant chemoradiotherapy (CRT) in patients with resected gastric cancer (GC). However, a subset of patients with lymph node (LN) positive disease may still benefit from CRT. Additional evidence is needed to help guide physicians in identifying patients in whom CRT should be considered. Our objective was then to compare survival outcomes based on lymph node ratio (LNR) (ratio of metastatic to harvested LNs) for patients with gastric and gastroesophageal junction (GEJ) adenocarcinoma treated with surgery and either CT or CRT.

methodsThis retrospective population-based study used California Cancer Registry (CCR) data from 2004 to 2013. It included 1,493 patients diagnosed with stage IB-III gastric/GEJ adenocarcinoma and treated with CT or CRT following total or partial gastrectomy. Overall survival (OS) was the primary outcome and GC-specific survival was secondary. Mortality hazards ratios (HR) for these outcomes were computed using propensity score weighted Cox regression models, stratified by LNR strata categories as 0%, 1-9%, 10-25% and >25%.

resultsOut of 1,493 patients that met inclusion criteria, 462 were treated with CT while 1,031 received CRT. Median follow-up for all subjects was 76 months and median survival was 54 months for CRT and 35 for the CT cohort, P<0.001. Compared to CT, CRT was associated with improved survival among patients with LNR of 10-25% [HR =0.62 (95% CI, 0.46-0.83)] and >25% [HR =0.67 (95% CI, 0.56-0.80)]. Similar findings were observed for GC-specific survival and for analyses limited to patients that had at least 15 LNs evaluated.

conclusionsLNR appears to be a simple and readily available measure that could be used in treatment planning for resected GC. CRT offers significant survival advantage over CT among patients with high LN disease burden (LNR of ≥10%).

Indexed as

adjuvant therapyGastric cancer (GC)lymph node ratio (LNR)

Identifiers

PMID30151267
PMCPMC6087859

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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.