Evidence map›Paper›PMID 31313044›Full record

ArticleAnnals of surgical oncology2019

Completion of Adjuvant Chemotherapy After Upfront Surgical Resection for Pancreatic Cancer Is Uncommon Yet Associated With Improved Survival.

Ariella M Altman, Keith Wirth, Schelomo Marmor, Emil Lou, Katherine Chang, Jane Y C Hui, Todd M Tuttle, Eric H Jensen, Jason W Denbo

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 3 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

70 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  3. Patient experience and quality of life during neoadjuvant therapy for pancreatic cancer: a systematic review and study protocol.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
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10 more citing papers are in PubMed but not listed here.

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.

Ariella M AltmanDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Keith WirthDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Schelomo MarmorDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Emil LouDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Katherine ChangDivision of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Jane Y C HuiDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Todd M TuttleDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Eric H JensenDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Jason W DenboDivision of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA. jason.denbo@moffitt.org.

Funding

Training the Next Generation of Surgeon-Scientists in PancreatologyT32DK108733 · NIDDK · UNIVERSITY OF MINNESOTA · PI Srinath Chinnakotla, MASATO YAMAMOTO · 2017 to 2026
$1.4M
NIDDK NIH HHS NIH/NIDDK T32K108733NIDDK NIH HHS T32 DK108733University of Minnesota IBARS ScholarshipUniversity of Minnesota VFW Fund
6 · The paper itself

Abstract

backgroundMultiple trials have demonstrated a survival benefit for adjuvant chemotherapy after resection of pancreatic adenocarcinoma. This study aimed to identify the rate for completion of adjuvant chemotherapy, factors associated with completion, and its impact on survival after surgical resection.

methodsThe Surveillance Epidemiology and End Results Medicare-linked data was used to identify patients who underwent upfront resection for pancreatic adenocarcinoma from 2004 to 2013. Billing codes were used to quantify receipt and completion of chemotherapy. Factors associated with completion of chemotherapy were identified using multivariable regression. Kaplan-Meier and Cox proportional-hazards modeling were used to examine survival.

resultsThe inclusion criteria were met by 2440 patients. Of these patients, 65% received no adjuvant chemotherapy, 28% received incomplete therapy, and 7% completed chemotherapy. The factors associated with chemotherapy completion were nodal metastases and treatment at a National Cancer Institute-designated cancer center (p ≤ 0.05). Comorbidities decreased the odds of completion (p ≤ 0.05). The median overall survival (OS) was 14 months for the patients who received no adjuvant chemotherapy, 17 months for those who received incomplete adjuvant chemotherapy, and 22 months for those who completed adjuvant chemotherapy (p ≤ 0.05). More recent diagnosis, comorbidities, T stage, nodal metastases, and no adjuvant chemotherapy were associated with an increased hazard ratio for death (p ≤ 0.05). Evaluation of 15 or more nodes and completion of chemotherapy decreased the hazard ratio for death (p ≤ 0.05).

conclusionsOnly 7% of the Medicare patients who underwent upfront resection for pancreatic cancer completed adjuvant chemotherapy, yet completion of adjuvant chemotherapy was associated with improved OS. Completion of adjuvant chemotherapy should be the goal after upfront resection, but neoadjuvant chemotherapy may ensure that patients receive systemic chemotherapy.

Indexed as

AdenocarcinomaAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID31313044
PMCPMC11982014

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.