Evidence map›Paper›PMID 30847552›Full record

ArticleJournal of cancer research and clinical oncology2019

Pathologic necrosis following neoadjuvant radiotherapy or chemoradiotherapy is prognostic of poor survival in soft tissue sarcoma.

Nicholas P Gannon, Matthew H Stemm, David M King, Meena Bedi

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cancer research and clinical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 11% 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

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Moderate hypofractionated radiation therapy and pathologic response for soft tissue sarcomas (STS) of limbs and trunk: experience from a tertiary cancer center.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. 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

4 authors at 2 institutions in 1 country.

Nicholas P GannonDepartment of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Matthew H StemmCGH Medical Center, Sterling, IL, 61081, USA.
David M KingDepartment of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Meena BediDepartment of Radiation Oncology, Medical College of Wisconsin, 9200 West Wisconsin Ave, Milwaukee, WI, 53226, USA. mbedi@mcw.edu.
Medical College of Wisconsin · USCGH Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeoadjuvant radiotherapy ± chemotherapy and wide local excision is an accepted management of localized soft tissue sarcomas (STS). Necrosis is prognostic for survival in osteosarcomas, but the significance for STS is undetermined. This study aimed to determine if percent true necrosis, opposed to a combination of necrosis and fibrosis, leads to improved survival in extremity and trunk STS.

methodsFrom 2000 to 2015, 162 patients with STS were treated with neoadjuvant therapy and resection. Patient and tumor variables were reviewed, and resected specimens underwent pathological assessment. Necrosis was ratiometrically determined. Overall (OS), distant metastasis-free (DMFS), and progression-free survival (PFS) were calculated using Kaplan-Meier estimator. Survival was determined using the Fisher's exact test for univariate analysis (UVA) and logistic regression for multivariate analysis (MVA).

resultsMedian follow-up was 4.5 years and median necrosis was 24.97%. Necrosis predicted worse OS, DMFS, and PFS on UVA, and DMFS and PFS on MVA. Necrosis was positively correlated with size and grade. To mitigate the role of size, a sub-analysis of ≥ 10 cm tumors was performed revealing necrosis predicted decreased DMFS and PFS on UVA and MVA. In high-grade tumors, necrosis correlated with decreased DMFS and PFS on UVA. Necrosis did not predict OS in ≥ 10 cm or high-grade tumors.

conclusionsOur data suggests necrosis may be an additional independent, prognostic variable with increased necrosis predicting a worse prognosis. Necrosis may not be a measure of treatment response and instead suggests more aggressive tumor biology as high-grade, large STS were associated with increased necrosis.

Indexed as

AdolescentAdultAgedAged, 80 and overBiomarkersChemoradiotherapyCombined Modality TherapyComorbidityFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNecrosisNeoadjuvant TherapyNeoplasm GradingBiomarkersMetastasisOutcomePreoperativeRadiationRecurrence

Identifiers

PMID30847552
PMCPMC11810344
OpenAlexW2922098050

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.