Evidence map›Paper›PMID 30171396›Full record

ArticleSurgical endoscopy2019

Laparoscopic versus open resection of gastrointestinal stromal tumors: survival outcomes from the NCDB.

Colette S Inaba, Austin Dosch, Christina Y Koh, Sarath Sujatha-Bhaskar, Marija Pejcinovska, Brian R Smith, Ninh T Nguyen

Registry-linked trialAbstract readComparative Study
PubMed Publisher
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. It is linked to trial NCT04344847 (Incidental Finding of Gastrointestinal Stromal Tumors), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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.

NCT04344847 naunknown statusnot on this map

Incidental Finding of Gastrointestinal Stromal Tumors (GISTs) During Laparoscopic Sleeve Gastrectomy, How to Deal? How Much Safety Margin

TypeinterventionalSponsorBassem Mohamed SiedaRan2016 to 2020Enrolled338ConditionsExcision MarginArmsLaparoscopic sleeve gastrectomy
3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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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

7 authors.

Colette S InabaDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Austin DoschDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Christina Y KohDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Sarath Sujatha-BhaskarDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Marija PejcinovskaCenter for Statistical Consulting, University of California Irvine, Irvine, CA, USA.
Brian R SmithDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA.
Ninh T NguyenDepartment of Surgery, University of California Irvine Medical Center, Orange, CA, USA. ninhn@uci.edu.

Funding

Research Training Program in Surgical OncologyT32CA211034 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI MERCHANT, NIPUN B. · 2016 to 2025
$2.7M
6 · The paper itself

Abstract

backgroundStudies comparing laparoscopic versus open resection of gastrointestinal stromal tumors (GIST) typically involve small comparative groups and often do not control for tumor size or stage of disease. The objective of this study was to compare adjusted survival outcomes for laparoscopic versus open GIST.

methodThe National Cancer Database (NCDB) from 2010 to 2014 was evaluated for gastric and small intestinal GIST resections. After stratification by disease stage and adjustment for patient demographics, comorbidity score, tumor size, and tumor location, 90-day mortality rates were compared based on laparoscopic versus open resection. Kaplan-Meier estimates of long-term survival were also compared. A Cox proportional hazards model was used to determine hazard ratios (HR) for survival.

resultsThere were 5096 cases analyzed, including 2910 (57%) stage I, 954 (19%) stage II, and 1232 (24%) stage III cases. The distribution of laparoscopic versus open cases was 1291 (44%) versus 1619 (56%) for stage I, 318 (33%) versus 636 (67%) for stage II, and 286 (23%) versus 946 (77%) for stage III. There was no significant difference in adjusted 90-day mortality between laparoscopic and open resection. Kaplan-Meier estimates of long-term survival demonstrated improved overall survival curves for laparoscopic resection for stage I and stage II disease, but no significant difference for stage III disease. Factors associated with statistically significant higher adjusted overall mortality included older age (HR 1.06; p < 0.001), black race (HR 1.33; p = 0.04), higher comorbidity score (HR 1.47; p < 0.001), and small intestinal versus gastric tumor location (HR 1.28; p = 0.03). The hazards model suggested improved overall survival for females (HR 0.59; p < 0.001) and laparoscopic approach (HR 0.80; p = 0.06).

conclusionLaparoscopic and open GIST resection have comparable 90-day mortality with possible improved long-term survival with laparoscopy for early-stage disease. These findings support the use of laparoscopy as a viable and potentially more effective approach to GIST resection.

Indexed as

LaparoscopyAdultAgedDatabases, FactualFemaleGastrectomyGastrointestinal NeoplasmsGastrointestinal Stromal TumorsHumansIntestine, SmallMaleMiddle AgedNeoplasm StagingRisk FactorsSurvival AnalysisTreatment OutcomeGastrointestinal stromal tumorGISTLaparoscopic versus open surgeryNCDBOutcomesSurvival

Identifiers

PMID30171396

What OpenQuestion holds

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Registered trials

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.