Evidence map›Paper›PMID 31283562›Full record

ArticleAnnals of surgery2019

A Novel Validated Recurrence Risk Score to Guide a Pragmatic Surveillance Strategy After Resection of Pancreatic Neuroendocrine Tumors: An International Study of 1006 Patients.

Mohammad Y Zaidi, Alexandra G Lopez-Aguiar, Jeffrey M Switchenko, Joseph Lipscomb, Valentina Andreasi, Stefano Partelli, Adriana C Gamboa, Rachel M Lee, George A Poultsides, Mary Dillhoff and 8 more

Open access · greenAbstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 4 pooled it
6.4field-weighted citation impact, top 3% 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

37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 79 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

18 authors at 9 institutions in 2 countries.

Mohammad Y ZaidiDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Alexandra G Lopez-AguiarDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Jeffrey M SwitchenkoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.
Joseph LipscombDepartment of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA.
Valentina AndreasiPancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy.
Stefano PartelliPancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy.
Adriana C GamboaDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Rachel M LeeDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
George A PoultsidesDepartment of Surgery, Stanford University Medical Center, Stanford, CA.
Mary DillhoffDivision of Surgical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH.
Flavio G RochaDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA.
Kamran IdreesDivision of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
Clifford S ChoDepartment of Surgery, Division of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, University of Michigan, Ann Arbor, MI.
Sharon M WeberDepartment of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St Louis, MO.
Charles A StaleyDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Massimo FalconiPancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy.
Shishir K MaithelDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Emory University · USVita-Salute San Raffaele University · ITStanford Medicine · USThe Ohio State University · USUniversity of Michigan–Ann Arbor · USUniversity of Wisconsin–Madison · USVanderbilt University Medical Center · USVirginia Mason Medical Center · USWashington University in St. Louis · US

Funding

Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI MADHAV V DHODAPKAR · 2009 to 2026
$47.5M
Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
NCI NIH HHS K12 CA090625NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

objectiveDespite heterogeneous biology, similar surveillance schemas are utilized after resection of all pancreatic neuroendocrine tumors (PanNETs). Given concerns regarding excess radiation exposure and financial burden, our aim was to develop a prognostic score for disease recurrence to guide individually tailored surveillance strategies.

methodsAll patients with primary nonfunctioning, nonmetastatic well/moderately differentiated PanNETs who underwent curative-intent resection at 9-institutions from 2000 to 2016 were included (n = 1006). A Recurrence Risk Score (RRS) was developed from a randomly selected derivation cohort comprised of 67% of patients and verified on the validation-cohort comprised of the remaining 33%.

resultsOn multivariable analysis, patients within the derivation cohort (n = 681) with symptomatic tumors (jaundice, pain, bleeding), tumors >2 cm, Ki67 >3%, and lymph node (LN) (+) disease had increased recurrence. Each factor was assigned a score based on their weighted odds ratio that formed a RRS of 0 to 10: symptomatic = 1, tumor >2 cm = 2, Ki67 3% to 20% = 1, Ki67 >20% = 6, LN (+) = 1. Patients were grouped into low- (RRS = 0-2; n = 247), intermediate-(RRS = 3-5; n = 204), or high (RRS = 6-10; n = 9)-risk groups. At 24 months, 33% of high RRS recurred, whereas only 2% of low and 14% of intermediate RRS recurred. This persisted in the validation cohort (n = 325).

conclusionsThis international, novel, internally validated RRS accurately stratifies recurrence-free survival for patients with resected PanNETs. Given their unique recurrence patterns, surveillance intervals of 12, 6, and 3 months are proposed for low, intermediate, and high RRS patients, respectively, to minimize radiation exposure and optimize cost/resource utilization.

Indexed as

AdultAgedCohort StudiesCost-Benefit AnalysisDatabases, FactualDisease-Free SurvivalFemaleHumansInternationalityKaplan-Meier EstimateMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisNeoplasm Recurrence, LocalNeuroendocrine Tumors

Identifiers

PMID31283562
PMCPMC6697205
OpenAlexW2961484375

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.