Evidence map›Paper›PMID 30328070›Full record

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

Surgical Delay Is Associated with Improved Survival in Hepatocellular Carcinoma: Results of the National Cancer Database.

Kerui Xu, Shinobu Watanabe-Galloway, Fedja A Rochling, Paraskevi A Farazi, K M Monirul Islam, Hongmei Wang, Jiangtao Luo

Abstract read
PubMed Full text at PMC 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 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
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

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. Article
  2. Time to surgery in patients with colorectal liver metastases.World journal of surgical oncology · 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

7 authors at 2 institutions in 1 country.

Kerui XuWisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, 53726, USA. xuk@surgery.wisc.edu.ORCID 0000-0002-4230-4980
Shinobu Watanabe-GallowayDepartment of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
Fedja A RochlingDivision of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-2000, USA.
Paraskevi A FaraziDepartment of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
K M Monirul IslamDepartment of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
Hongmei WangDepartment of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4350, USA.
Jiangtao LuoDepartment of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4375, USA.
University of Nebraska Medical Center · USNebraska Medical Center · US

Funding

Tracking and Evaluation CoreU54GM115458 · NIGMS · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI RIZZO, MATTHEW · 2016 to 2025
$42.8M
NIGMS NIH HHS U54 GM115458
6 · The paper itself

Abstract

backgroundHepatocellular carcinoma (HCC) is one of the fastest growing causes of cancer-related death in the USA. Studies that investigated the impact of HCC therapeutic delays are limited to single centers, and no large-scale database research has been conducted. This study investigated the association of surgical delay and survival in HCC patients.

methodsPatients underwent local tumor destruction and hepatic resection for stages I-III HCC were identified from the 2004 to 2013 Commission on Cancer's National Cancer Database. Surgical delay was defined as > 60 days from the date of diagnosis to surgery. Generalized linear-mixed model assessed the demographic and clinical factors associated with delay, and frailty Cox proportional hazard analysis examined the prognostic factors for overall survival.

resultsA total of 12,102 HCC patients met the eligibility criteria. Median wait time to surgery was 50 days (interquartile range, 29-86), and 4987 patients (41.2%) had surgical delay. Delayed patients demonstrated better 5-year survival for local tumor destruction (29.1 vs. 27.6%; P = .001) and resection (44.1 vs. 41.0%; P = .007). Risk-adjusted model indicated that delayed patients had a 7% decreased risk of death (HR, 0.93; 95% CI, 0.87-0.99; P = .027). Similar findings were also observed using other wait time cutoffs at 50, 70, 80, 90, and 100 days.

conclusionsA plausible explanation of this finding may be case prioritization, in which patients with more severe and advanced disease who were at higher risk of death received earlier surgery, while patients with less-aggressive tumors were operated on later and received more comprehensive preoperative evaluation.

Indexed as

AdultAgedCarcinoma, HepatocellularDatabases, FactualFemaleFollow-Up StudiesHepatectomyHumansLiver NeoplasmsMaleMiddle AgedNeoplasm StagingRetrospective StudiesRisk AdjustmentSurvival AnalysisTime-to-TreatmentCancer survivalHepatocellular carcinomaNational Cancer DatabaseSurgical delayWait time

Identifiers

PMID30328070
PMCPMC12110860
OpenAlexW2890380642

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.