Evidence map›Paper›PMID 31304767›Full record

SynthesisAnnals of the Royal College of Surgeons of England2019

Systemic neoadjuvant chemotherapy in modern pancreatic cancer treatment: a systematic review and meta-analysis.

K Rangarajan, P H Pucher, T Armstrong, A Bateman, Zzr Hamady

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of the Royal College of Surgeons of England, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 7% 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

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.

  1. Pooled it
  2. Article
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  5. Review
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  7. Article
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  14. Review
  15. Neoadjuvant FOLFIRINOX Therapy Is Associated with Increased Effector T Cells and Reduced Suppressor Cells in Patients with Pancreatic Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2021
    Article
  16. Article
  17. Impact of postoperative pancreatic fistula on long-term oncologic outcomes after pancreatic resection.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2021
    Article
  18. Review
  19. Article
  20. 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

5 authors at 2 institutions in 1 country.

K RangarajanDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
P H PucherDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
T ArmstrongDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
A BatemanDepartment of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Zzr HamadyDepartment of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
University Hospital Southampton NHS Foundation Trust · GBSt Mary's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatic ductal adenocarcinoma remains a disease with a poor prognosis despite advances in surgery and systemic therapies. Neoadjuvant therapy strategies are a promising alternative to adjuvant chemotherapy. However, their role remains controversial. This meta-analysis aims to clarify the benefits of neoadjuvant therapy in resectable pancreatic ductal adenocarcinoma.

methodsEligible studies were identified from MEDLINE, Embase, Web of Science and the Cochrane Library. Studies comparing neoadjuvant therapy with a surgery first approach (with or without adjuvant therapy) in resectable pancreatic ductal adenocarcinoma were included. The primary outcome assessed was overall survival. A random-effects meta-analysis was performed, together with pooling of unadjusted Kaplan-Meier curve data.

resultsA total of 533 studies were identified that analysed the effect of neoadjuvant therapy in pancreatic ductal adenocarcinoma. Twenty-seven studies were included in the final data synthesis. Meta-analysis suggested beneficial effects of neoadjuvant therapy with prolonged survival compared with a surgery-first approach, (hazard ratio 0.72, 95% confidence interval 0.69-0.76). In addition, R0 resection rates were significantly higher in patients receiving neoadjuvant therapy (relative risk 0.51, 95% confidence interval 0.47-0.55). Individual patient data analysis suggested that overall survival was better for patients receiving neoadjuvant therapy (

conclusionsCurrent evidence suggests that neoadjuvant chemotherapy has a beneficial effect on overall survival in resectable pancreatic ductal adenocarcinoma in comparison with upfront surgery and adjuvant therapy. Further trials are needed to address the need for practice change.

Indexed as

PancreatectomyAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalDisease-Free SurvivalHumansNeoadjuvant TherapyPancreatic NeoplasmsPrognosisSurvival AnalysisTime FactorsCancerNeoadjuvantPancreasSurgery

Identifiers

PMID31304767
PMCPMC6667953
OpenAlexW2956690984

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.