Evidence map›Paper›PMID 32740733›Full record

ArticleAnnals of surgical oncology2020

Patterns of Failure and the Need for Biliary Intervention in Resected Biliary Tract Cancers After Chemoradiation.

Edward Christopher Dee, Morgan E Freret, Nora Horick, Ann C Raldow, Lipika Goyal, Andrew X Zhu, Aparna R Parikh, David P Ryan, Jeffrey W Clark, Jill N Allen and 7 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 1 country.

Edward Christopher DeeHarvard Medical School, Boston, MA, USA.
Morgan E FreretDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Nora HorickBiostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
Ann C RaldowDepartment of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA.
Lipika GoyalDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Andrew X ZhuDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Aparna R ParikhDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
David P RyanDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jeffrey W ClarkDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jill N AllenDepartment of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cristina R FerroneDepartment of General and Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Carlos Fernandez-Del CastilloDepartment of General and Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Kenneth K TanabeDepartment of Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Lorraine C DrapekDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Theodore S HongDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Motaz QadanDepartment of General and Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jennifer Y WoDepartment of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. jwo@mgh.harvard.edu.
Massachusetts General Hospital · USHarvard University · USMemorial Sloan Kettering Cancer Center · USUniversity of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study assessed patterns of failure and rates of subsequent biliary intervention among patients with resected biliary tract cancers (BTCs) including gallbladder carcinoma (GBC) and extra- and intrahepatic cholangiocarcinoma (eCCA and iCCA) treated with adjuvant chemoradiation therapy (CRT).

methodsIn this single-institution retrospective analysis of 80 patients who had GBC (n = 29), eCCA (n = 43), or iCCA (n = 8) treated with curative-intent resection and adjuvant CRT from 2007 to 2017, the median radiation dose was 50.4 Gy (range 36-65 Gy) with concurrent 5-fluorouracil (5-FU) chemotherapy. All but two of the patients received adjuvant chemotherapy. The 2-year locoregional failure (LRF), 2-year recurrence-free survival (RFS), and 2-year overall survival (OS), and univariate predictors of LRF, RFS, and OS were calculated for the entire cohort and for a subgroup excluding patients with iCCA (n = 72). The predictors of biliary interventions also were assessed.

resultsOf the 80 patients (median follow-up period, 30.5 months; median OS, 33.9 months), 54.4% had American Joint Committee on Cancer (AJCC) stage 1 or 2 disease, 57.1% were lymph node-positive, and 66.3% underwent margin-negative resection. For the entire cohort, 2-year LRF was 23.8%, 2-year RFS was  43.7%, and 2-year OS was 62.1%.  When patients with iCCA were excluded, the 2-year LRF was 22.6%, the 2-year RFS was 43.9%, and the 2-year OS was 59.2%. In the overall and subgroup univariate analyses, lymph node positivity was associated with greater LRF, whereas resection margin was not. Biliary intervention was required for 12 (63.2%) of the 19 patients with LRF versus 11 (18%) of the 61 patients without LRF (P < 0.001). Of the 12 patients with LRF who required biliary intervention, 4 died of biliary complications.

conclusionsThe LRF rates remained significant despite adjuvant CRT. Lymph node positivity may be associated with increased risk of LRF. Positive margins were not associated with greater LRF, suggesting that CRT may mitigate LRF risk for this group. An association between LRF and higher rates of subsequent biliary interventions was observed, which may yield significant morbidity. Novel strategies to decrease the rates of LRF should be considered.

Indexed as

Bile Duct NeoplasmsBiliary Tract NeoplasmsChemotherapy, AdjuvantFluorouracilHumansRetrospective StudiesFluorouracil

Identifiers

PMID32740733
OpenAlexW3046250754

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.