Evidence map›Paper›PMID 30788714›Full record

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

Influence of Neoadjuvant Radiation Dose on Patients Undergoing Esophagectomy and Survival in Locally Advanced Esophageal Cancer.

Mickey S Ising, Katy Marino, Jaimin R Trivedi, Adam A Rojan, Neal E Dunlap, Victor van Berkel, Matthew P Fox

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Radiation doses in esophageal cancer.Journal of thoracic disease · 2019
    Article
  12. 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

7 authors.

Mickey S IsingDepartment of Surgery, University of Louisville School of Medicine, 201 Abraham Flexner Way, Ste 1200, Louisville, KY, 40202, USA.ORCID 0000-0002-8951-167X
Katy MarinoDepartment of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Jaimin R TrivediDepartment of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Adam A RojanDivision of Medical Oncology and Hematology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
Neal E DunlapDepartment of Radiation Oncology, Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY, USA.
Victor van BerkelDepartment of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
Matthew P FoxDepartment of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA. Matthew.Fox@ulp.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant chemoradiotherapy followed by resection is standard of care for patients with locally advanced esophageal cancer, however, a significant portion of these patients do not undergo surgical intervention. This study evaluates radiation dose and other factors associated with undergoing esophageal resection and their impact on outcomes including survival.

methodsPatients diagnosed with esophageal cancer between 2010 and 15 were queried from the National Cancer Database and stratified into low-dose radiation (41.4 Gy) (LDR) or high-dose radiation (50.0 or 50.4 Gy) (HDR) groups. Multivariable Logistic and Cox Regression analyses were performed to investigate the effect of multiple variables on the likelihood of undergoing esophagectomy and overall survival, respectively. Propensity score matching was performed to reduce bias between groups.

resultsA total of 3633 patients met study criteria with 3005 (82.7%) undergoing esophagectomy. A greater proportion received HDR (3163 (87.1%)) than LDR (470 (12.9%)). The use of LDR increased from 4.7% (n = 22) in 2010 to 20.7% (n = 154) in 2015. Factors associated with undergoing esophagectomy included LDR, adenocarcinoma histology, and younger age. Radiation dosage did not impact overall survival, but undergoing esophagectomy was associated with improved survival. After propensity matching, a greater portion of the LDR group underwent esophagectomy (87.0 vs 81.1%, p = 0.013). There was no difference in R0 3 resection (93.2 vs 92.4%, p = 0.678) or complete pathologic response (19.3 vs 21.5%, p = 0.442) between LDR and HDR groups.

conclusionThe use of LDR is increasing but still underutilized. LDR is associated with increased rates of esophagectomy without negatively impacting overall survival, R0 resection, or complete pathologic response.

Indexed as

EsophagectomyNeoadjuvant TherapyRadiation DosageAdenocarcinomaAdultAgedAged, 80 and overCarcinoma, Squamous CellDatabases, FactualEsophageal NeoplasmsFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingEsophageal cancerEsophagectomyRadiation dosage

Identifiers

PMID30788714

What OpenQuestion holds

Textmetadata
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.