Evidence map›Paper›PMID 32671796›Full record

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

Hepatic Steatosis After Neoadjuvant Chemotherapy for Pancreatic Cancer: Incidence and Implications for Outcomes After Pancreatoduodenectomy.

K F Flick, M H Al-Temimi, T K Maatman, C M Sublette, J K Swensson, A Nakeeb, E P Ceppa, T K Nguyen, C M Schmidt, N J Zyromski and 2 more

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

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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 48% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. 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

12 authors at 2 institutions in 1 country.

K F FlickDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
M H Al-TemimiDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
T K MaatmanDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
C M SubletteIndiana University School of Medicine, Indianapolis, IN, USA.
J K SwenssonDepartment of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
A NakeebDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
E P CeppaDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
T K NguyenDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
C M SchmidtDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
N J ZyromskiDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA.
M A TannDepartment of Radiology, Indiana University School of Medicine, Indianapolis, IN, USA.
M G HouseDepartment of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 515, Indianapolis, IN, 46202, USA. michouse@iupui.edu.
Indiana University School of MedicineIndiana University – Purdue University Indianapolis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to determine the incidence of new onset hepatic steatosis after neoadjuvant chemotherapy for pancreatic cancer and its impact on outcomes after pancreatoduodenectomy.

methodsRetrospective review identified patients who received neoadjuvant chemotherapy for pancreatic adenocarcinoma and underwent pancreatoduodenectomy from 2013 to 2018. Preoperative computed tomography scans were evaluated for the development of hepatic steatosis after neoadjuvant chemotherapy. Hypoattenuation included liver attenuation greater than or equal to 10 Hounsfield units less than tissue density of spleen on noncontrast computed tomography and greater than or equal to 20 Hounsfield units less on contrast-enhanced computed tomography.

resultsOne hundred forty-nine patients received neoadjuvant chemotherapy for a median of 5 cycles (interquartile range (IQR), 4-6). FOLFIRINOX was the regimen in 78% of patients. Hepatic steatosis developed in 36 (24%) patients. The median time from neoadjuvant chemotherapy completion to pancreatoduodenectomy was 40 days (IQR, 29-51). Preoperative biliary stenting was performed in 126 (86%) patients. Neoadjuvant radiotherapy was delivered to 23 (15%) patients. Female gender, obesity, and prolonged exposure to chemotherapy were identified as risk factors for chemotherapy-associated hepatic steatosis. Compared with control patients without neoadjuvant chemotherapy-associated hepatic steatosis, patients developing steatosis had similar rates of postoperative pancreatic fistula (8% (control) vs. 4%, p = 0.3), delayed gastric emptying (8% vs. 14%, p = 0.4), and major morbidity (11% vs. 15%, p = 0.6). Ninety-day mortality was similar between groups (8% vs. 2%, p = 0.08).

conclusionHepatic steatosis developed in 24% of patients who received neoadjuvant chemotherapy but was not associated with increased morbidity or mortality after pancreatoduodenectomy.

Indexed as

AdenocarcinomaPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsFemaleHumansIncidenceNeoadjuvant TherapyPancreaticoduodenectomyRetrospective StudiesHepatic steatosisNeoadjuvant therapyPancreatic cancer

Identifiers

PMID32671796
PMCPMC7363010
OpenAlexW3043359443

What OpenQuestion holds

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Registered trials

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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.