Evidence map›Paper›PMID 33634422›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

The Utility of Preoperative Tumor Markers in Peritoneal Carcinomatosis from Primary Appendiceal Adenocarcinoma: an Analysis from the US HIPEC Collaborative.

Nadege Fackche, Ryan K Schmocker, Boateng Kubi, Jordan M Cloyd, Ahmed Ahmed, Travis Grotz, Jennifer Leiting, Keith Fournier, Andrew J Lee, Benjamin Powers and 17 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Observational
  3. Article
  4. Review
  5. 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

27 authors at 12 institutions in 1 country.

Nadege FackcheDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Ryan K SchmockerDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Boateng KubiDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Jordan M CloydDivision of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Ahmed AhmedDivision of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Travis GrotzDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Jennifer LeitingDivision of Hepatobiliary and Pancreas Surgery, Mayo Clinic, Rochester, MN, USA.
Keith FournierDepartment of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Andrew J LeeDepartment of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Benjamin PowersDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Department of Oncologic Sciences, Morsani College of Medicine, Tampa, FL, USA.
Sean DineenDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Department of Oncologic Sciences, Morsani College of Medicine, Tampa, FL, USA.
Jula VeerapongDivision of Surgical Oncology, Department of Surgery, University of California, San Diego, La Jolla, CA, USA.
Joel M BaumgartnerDivision of Surgical Oncology, Department of Surgery, University of California, San Diego, La Jolla, CA, USA.
Callisia ClarkeDivision of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
T Clark GamblinDivision of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Sameer H PatelDepartment of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Vikrom DharDepartment of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Ryan J HendrixDivision of Surgical Oncology, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
Laura LambertDivision of Surgical Oncology, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USA.
Daniel E AbbottDivision of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA.
Courtney PokrzywaDivision of Surgical Oncology, Department of Surgery, University of Wisconsin, Madison, WI, USA.
Kelly LafaroDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, South Pasadena, CA, USA.
Byrne LeeDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, South Pasadena, CA, USA.
Mohammad Y ZaidiDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Shishir K MaithelDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Fabian M JohnstonDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Jonathan B GreerDivision of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA. jgreer13@jhmi.edu.ORCID 0000-0001-8968-9710
Johns Hopkins University · USCity Of Hope National Medical Center · USEmory University · USMayo Clinic in Arizona · USMedical College of Wisconsin · USMoffitt Cancer Center · USThe Ohio State University Wexner Medical Center · USThe University of Texas MD Anderson Cancer Center · USUniversity of California San Diego · USUniversity of Cincinnati Medical Center · USUniversity of Massachusetts Chan Medical School · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrognostication based on preoperative clinical factors is lacking in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). This study aims to determine the value of preoperative tumor markers as predictors of progression-free survival (PFS) and overall survival (OS) for patients with peritoneal carcinomatosis from a primary mucinous adenocarcinoma of the appendix (MACA).

methodsWe queried the United States HIPEC Collaborative, a database of patients with peritoneal carcinomatosis treated with CRS/HIPEC at twelve institutions between 2000 and 2017, identifying 409 patients with MACA. Multivariate analysis was used to identify independent predictors of disease progression. Subgroup analysis was conducted to evaluate the impact of tumor grade on the predictive value of tumor markers.

resultsCA19-9 [HR 2.44, CI 1.2-3.4] emerged as an independent predictor of PFS while CEA [HR 4.98, CI 1.06-23.46] was independently predictive of OS (p <0.01). Tumor differentiation was the most potent predictor of both PFS (poorly differentiated vs well, [HR 4.5 CI 2.01-9.94]) and OS ([poorly differentiated vs well-differentiated: [HR 13.5, CI 3.16-57.78]), p <0.05. Among patients with combined CA19-9 elevation and poorly differentiated histology, 86% recurred within a year of CRS/HIPEC (p < 0.01). Similarly, the coexistence of CEA elevation and unfavorable histology led to the lowest survival rate at two years [36%, p < 0.01]. CA-125 was not predictive of PFS or OS.

conclusionElevated preoperative CA19-9 portends worse PFS, while elevated CEA predicts worse OS after CRS/HIPEC in patients with MACA. This study provides additional evidence that CA19-9 and CEA levels should be collected during standard preoperative bloodwork, while CA-125 can likely be omitted. Tumor differentiation, when added to preoperative tumor marker levels, provides powerful prognostic information. Prospective studies are required to confirm this association.

Indexed as

AdenocarcinomaAppendiceal NeoplasmsAppendixHyperthermia, InducedPeritoneal NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorCombined Modality TherapyCytoreduction Surgical ProceduresHumansHyperthermic Intraperitoneal ChemotherapyRetrospective StudiesSurvival RateBiomarkers, TumorAppendiceal adenocarcinomaCRS/HIPECTumor markers

Identifiers

PMID33634422
OpenAlexW3132687407

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.