Evidence map›Paper›PMID 31420860›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020

National Trends in Centralization of Surgical Care and Multimodality Therapy for Pancreatic Adenocarcinoma.

Alexander V Fisher, Yue Ma, Xing Wang, Stephanie A Campbell-Flohr, Paul J Rathouz, Sean M Ronnekleiv-Kelly, Daniel E Abbott, Sharon M Weber

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 21% 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

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Review
  2. Article
  3. Socioeconomic Predictors of Access to Care for Patients with Operatively Managed Pancreatic Cancer in New York State.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
    Article
  4. Article
  5. Review
  6. 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

8 authors at 2 institutions in 1 country.

Alexander V FisherDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Yue MaDepartment of Medicine, University of Wisconsin, Madison, WI, USA.
Xing WangDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Stephanie A Campbell-FlohrDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Paul J RathouzDepartment of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA.
Sean M Ronnekleiv-KellyDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Daniel E AbbottDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA.
Sharon M WeberDepartment of Surgery, University of Wisconsin, 600 Highland Avenue, BX7375 Clinical Science Center, Madison, WI, 53792-3284, USA. webers@surgery.wisc.edu.
University of Wisconsin–Madison · USHighland Community College - Illinois · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStudies have demonstrated that multimodality therapy and surgery at high volume centers are associated with a longer survival. However, it is unknown if these data have translated into national changes in care delivery.

methodsPatients with stages I-III pancreatic adenocarcinomas who underwent resections between 2004 and 2010 were identified from the National Cancer Data Base. The primary outcome was a 3-year overall survival. Temporal trends in survival outcomes and treatment variables were measured. A mediation analysis using the Lin method was used to discern the relative contribution of changes in treatment variables towards improvements in survival over time.

resultsA total of 22,196 patients were identified. Between 2004 and 2010, a 90-day peri-operative mortality remained unchanged (8.5 % to 8.4 %, p = 0.488), 3-year overall survival improved from 26 to 30% (p < 0.001), use of adjuvant/neoadjuvant chemotherapy increased (51 % to 61 %, p < 0.001), and more cases shifted to high volume centers (46 % at institutions performing > 10 cases/year in 2004 vs. 65 % in 2010, p < 0.001). On multivariable analysis, 32 % of the improvement in survival over time was attributable to receipt of chemotherapy, while 12 % was due to the shift of patients towards high volume centers (p < 0.001).

conclusionsOver the period from 2004 to 2010, a 3-year survival increased for patients undergoing resection for pancreatic cancer. This survival improvement can be partially attributed to the increasing utilization of chemotherapy and centralization of surgical care at high volume centers. A continued emphasis on these factors will likely result in further prolongation of a survival following resection.

Indexed as

AdenocarcinomaPancreatic NeoplasmsChemotherapy, AdjuvantCombined Modality TherapyHumansNeoadjuvant TherapyPancreatectomyRetrospective StudiesSurvival RateCentralizationPancreatic cancer trendsSurvival

Identifiers

PMID31420860
OpenAlexW2968573245

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.