Evidence map›Paper›PMID 30788715›Full record

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

Evaluating Dissemination of Adequate Lymphadenectomy for Gastric Cancer in the USA.

Anthony M Villano, Alexander Zeymo, James McDermott, Andrew Crocker, Jay Zeck, Kitty S Chan, Nawar Shara, Sunnie Kim, Waddah B Al-Refaie

Abstract readMulticenter Study
PubMed 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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Gastric Cancer Surgery in the US: a Contemporary Trend Analysis of Lymphadenectomy and the Impact of Minimally Invasive Approaches.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
    Article
  4. 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

9 authors.

Anthony M VillanoMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA.
Alexander ZeymoMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA.
James McDermottMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA.
Andrew CrockerMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA.
Jay ZeckDepartment of Pathology, MedStar-Georgetown University Hospital, Washington, DC, USA.
Kitty S ChanMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA.
Nawar SharaDepartment of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, USA.
Sunnie KimDepartment of Hematology-Oncology, MedStar-Georgetown University Hospital, Washington, DC, USA.
Waddah B Al-RefaieMedStar-Georgetown Surgical Outcomes Research Center, Washington, DC, USA. Waddah.B.Al-Refaie@gunet.georgetown.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdequate lymphadenectomy (AL) of 15+ lymph nodes comprises an important component of gastric cancer surgical therapy. Despite endorsement by the National Comprehensive Cancer Network and the Committee on Cancer, initial adoption of this paradigm has been relatively slow. The current analysis sought to perform an adjusted time-trend evaluation of the factors associated with AL and its dissemination.

methodsUtilizing the 2004-2015 National Cancer Database, 28,985 patients were identified who underwent gastrectomy for adenocarcinoma. An adjusted time-trend analysis was performed to estimate the adoption of AL overall. Multivariable logistic regression was utilized to assess factors associated with these observed trends. Interactions and stratified models determined disparate effects in vulnerable populations (older adults, ethnic minorities, low socioeconomic status).

resultsThe adjusted time-trend analysis demonstrated an overall 30% increase (28.8 to 58.7%) in receipt of AL (OR 1.10 increase/year; 95%CI 1.09-1.10) from 2004 to 2015. This trend persisted even after stratifying the models by age, race/ethnicity, and income (OR 1.07-1.12; p < 0.05). Slowest rates of adoption were seen amongst hospitals in the Midwest census region (OR 1.08, CI 1.06-1.90) and comprehensive community hospitals (OR 1.08, CI 1.06-1.91) and with African-American patients (OR 1.09, CI 1.06-1.11) (all p < 0.05).

conclusionThis multi-center evaluation demonstrates increased adoption of AL during gastric cancer surgery in the USA overall and amongst vulnerable populations, although regional and racial disparities were observed. Future studies are needed to investigate reasons underlying racial and regional differences in receipt of AL.

Indexed as

AdenocarcinomaAgedFemaleGastrectomyHumansIncidenceLymphatic MetastasisLymph Node ExcisionLymph NodesMaleMiddle AgedNeoplasm StagingStomach NeoplasmsSurvival RateUnited StatesCancerDisparityGastricLymphadenectomyOutcomesVolume

Identifiers

PMID30788715

What OpenQuestion holds

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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.