Evidence map›Paper›PMID 30659439›Full record

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

Predictive Value of Chromogranin A and a Pre-Operative Risk Score to Predict Recurrence After Resection of Pancreatic Neuroendocrine Tumors.

Alexander V Fisher, Alexandra G Lopez-Aguiar, Victoria R Rendell, Courtney Pokrzywa, Flavio G Rocha, Zaheer S Kanji, George A Poultsides, Eleftherios A Makris, Mary E Dillhoff, Eliza W Beal and 10 more

Abstract readEvaluation Study
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 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing 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

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

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
  6. Review
  7. Article
  8. Observational
  9. Tumor burden score predicts tumor recurrence of non-functional pancreatic neuroendocrine tumors after curative resection.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2020
    Article
  10. Article
  11. Article
  12. Review
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

20 authors.

Alexander V FisherDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Alexandra G Lopez-AguiarDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Victoria R RendellDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Courtney PokrzywaDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Flavio G RochaDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
Zaheer S KanjiDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
George A PoultsidesDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
Eleftherios A MakrisDepartment of Surgery, Stanford University Medical Center, Stanford, CA, USA.
Mary E DillhoffDivision of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Eliza W BealDivision of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Roheena Z PanniDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Kamran IdreesDivision of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Paula Marincola SmithDivision of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Clifford S ChoDivision of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Megan V BeemsDivision of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Shishir K MaithelDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Emily R WinslowDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Daniel E AbbottDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Sharon M WeberDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA. webers@surgery.wisc.edu.

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
UW Surgical Oncology Research Training Program (UW-SORT)T32CA090217 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI Muhammed Murtaza, Heather B Neuman · 2001 to 2026
$8.3M
NCI NIH HHS K12 CA090625NCI NIH HHS T32 CA090217
6 · The paper itself

Abstract

introChromogranin A (CgA) may be prognostic for patients with neuroendocrine tumors; however, the clinical utility of this test is unclear.

methodsPatients undergoing resection for pancreatic neuroendocrine tumors (pNET) were selected from the eight institutions of the US Neuroendocrine Tumor Study Group database. Cox regression was used to identify pre-operative variables that predicted recurrence-free survival (RFS), and those with p < 0.1 were included in a risk score. The risk score was tested in a unique subset of the overall cohort.

resultsIn the entire cohort of 287 patients, median follow-up time was 37 months, and 5-year RFS was 73%. Cox regression analysis identified four variables for inclusion in the risk score: CgA > 5x ULN (HR 4.3, p = 0.01), tumor grade 2/3 (HR 3.7, p = 0.01), resection for recurrent disease (HR 6.2, p < 0.01), and tumor size > 4 cm (HR 4.5, p = 0.1). Each variable was assigned 1 point. Risk-score testing in the unique validation cohort of 63 patients revealed a 95% negative predictive value for recurrence in patients with zero points. DISCUSSION: This simple pre-operative risk scoring system resulted in a high degree of specificity for identifying patients at low-risk for tumor recurrence. This test can be utilized pre-operatively to aid informed decision-making.

Indexed as

Clinical Decision RulesAdolescentAdultAgedAged, 80 and overBiomarkers, TumorChromogranin AClinical Decision-MakingDatabases, FactualDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, LocalBiomarkers, TumorChromogranin AChromogranin APancreatic neuroendocrine tumorRecurrenceRisk score

Identifiers

PMID30659439
PMCPMC7723064

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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.