Evidence map›Paper›PMID 30457666›Full record

ArticleCancer2019

Role of adjuvant therapy in resected stage IA subcentimeter (T1a/T1b) pancreatic cancer.

Walid L Shaib, Amit Surya Narayan, Jeffrey M Switchenko, Sujata R Kane, Christina Wu, Mehmet Akce, Olatunji B Alese, Pretesh R Patel, Shishir K Maithel, Juan M Sarmiento and 2 more

Abstract read
In one paragraph

Article in Cancer, 2019. 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
0.8field-weighted citation impact, top 22% 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

10 citing papers in PubMed, 19 citations in OpenAlex.

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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 at 1 institution in 1 country.

Walid L ShaibDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0001-9388-0446
Amit Surya NarayanDepartment of Internal Medicine, Emory University, Atlanta, Georgia.
Jeffrey M SwitchenkoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Sujata R KaneDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Christina WuDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Mehmet AkceDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0003-4747-7722
Olatunji B AleseDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Pretesh R PatelDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Shishir K MaithelDepartment of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Juan M SarmientoDepartment of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
David A KoobyDepartment of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Bassel F El-RayesDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0002-2661-5746
Emory University · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

backgroundThe standard of care for patients with resected stage I to stage III pancreatic ductal adenocarcinoma (PDAC) is adjuvant gemcitabine-based chemotherapy. The role of adjuvant treatment in patients with subcentimeter, stage IA PDAC is unknown. The current study evaluated the effect of adjuvant treatment on survival outcomes among patients with American Joint Committee on Cancer/International Union Against Cancer stage IA (T1N0) resected PDAC using the National Cancer Data Base (NCDB).

methodsA retrospective review of the NCDB was conducted for patients diagnosed with T1 (tumor limited to the pancreas and measuring ≤2 cm in greatest dimension), lymph node-negative (N0), resected PDAC between 2004 and 2013. Patient demographics, histology, adjuvant treatment, and survival trends were examined. Kaplan-Meier analysis and log-rank tests were performed to determine the unadjusted association between overall survival (OS), tumor size, and treatment.

resultsA total of 876 patients met the inclusion criteria. The patients had a mean age of 66.2 years (range, 32-90 years); approximately 83.3% were white (730 patients) and 53.1% were female (465 patients). Approximately 45.9% of the patients had moderately differentiated tumor histology (402 patients); 70.0% (613 patients) had tumors measuring 1 to 2 cm (T1c) and 30.0% (263 patients) had tumors measuring <1 cm (T1a/T1b). Approximately 94.2% of patients had negative surgical margins (815 patients) and 46.9% (410 patients) received adjuvant therapy. The median OS was significantly different for patients who received adjuvant therapy compared with patients who did not (70.7 months vs 46.9 months; P = .0001). For patients with tumors measuring <1 cm, survival was not found to be significantly different between patients who received adjuvant treatment compared with those who did not (not reached vs 85.3 months; P = .54). In the multivariable analysis, none of the covariates (treatment group, Charlson-Deyo Score, age, insurance, and facility status) demonstrated significant differences for patients with tumors measuring <1 cm.

conclusionsThe current study is the first to demonstrate no survival benefit for adjuvant therapy in patients with resected subcentimeter PDAC.

Indexed as

AdultAgedAged, 80 and overAntimetabolites, AntineoplasticChemotherapy, AdjuvantCombined Modality TherapyDeoxycytidineFemaleGemcitabineHumansKaplan-Meier EstimateMaleMargins of ExcisionMiddle AgedNeoplasm StagingPancreatic NeoplasmsAntimetabolites, AntineoplasticDeoxycytidineGemcitabineadjuvant therapypancreatic cancersubcentimetersurvival

Identifiers

PMID30457666
PMCPMC6309502
OpenAlexW2901774205

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.