Evidence map›Paper›PMID 33119884›Full record

ArticleClinical & experimental metastasis2021

Is survival really better after repeated lung metastasectomy?

Francesca Fiorentino, Tom Treasure

Abstract readLetter
PubMed Publisher
In one paragraph

Article in Clinical & experimental metastasis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 29% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Outcomes and prognostic factors of repeat pulmonary metastasectomy.Interdisciplinary cardiovascular and thoracic surgery · 2024
    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

2 authors at 2 institutions in 1 country.

Francesca FiorentinoDepartment of Surgery and Cancer, Imperial College London, London, UK.
Tom TreasureClinical Operational Research Unit, University College London, London, UK. tom.treasure@gmail.com.ORCID 0000-0001-9358-7610
Imperial College London · GBUniversity College London · GB

Funding

Cancer Research UK 11393
6 · The paper itself

Abstract

Several groups have observed that average survival time after a second lung metastasectomy is longer than after a first metastasectomy. The randomised controlled trial Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) found no survival benefit from lung metastasectomy. In fact, median survival was longer, and four-year overall survival was higher, in the control group than in those randomly assigned to metastasectomy, although not significantly so. The illusion of benefit is because survival without metastasectomy has been assumed to be near zero, as stated in Society of Thoracic Surgeons' Expert Consensus Document on Pulmonary Metastasectomy 2019. It has been repeatedly found that survival is influenced by the selection of patients who have characteristics associated with better prognosis. The passage of time while monitoring and assessing patients, and observing their rate of progression, provides for immortal time bias. Reselection of the most favourable patients for repeated metastasectomy is the likely reason for any differences in survival between first and repeated metastasectomy operations.

Indexed as

Colorectal NeoplasmsHumansLung NeoplasmsMetastasectomyPneumonectomyPrognosisRandomized Controlled Trials as TopicReoperationSurvival RateColorectal cancerLung metastasectomySurvival analysis

Identifiers

PMID33119884
OpenAlexW3096372498

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.