Evidence map›Paper›PMID 33893494›Full record

SynthesisDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2022

Prognostic relevance of lymph node regression on survival in esophageal cancer: a systematic review and meta-analysis.

Eliza Hagens, Karina Tukanova, Sara Jamel, Mark van Berge Henegouwen, George B Hanna, Suzanne Gisbertz, Sheraz R Markar

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 7% 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

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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  18. Lymph node metastatic patterns and the development of multidisciplinary treatment for esophageal cancer.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023
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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

7 authors at 3 institutions in 2 countries.

Eliza HagensDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
Karina TukanovaDepartment of Surgery and Cancer, Imperial College London, London, UK.
Sara JamelDepartment of Surgery and Cancer, Imperial College London, London, UK.
Mark van Berge HenegouwenDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
George B HannaDepartment of Surgery and Cancer, Imperial College London, London, UK.
Suzanne GisbertzDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
Sheraz R MarkarDepartment of Surgery and Cancer, Imperial College London, London, UK.
Imperial College London · GBAmsterdam University Medical Centers · NLUniversity of Amsterdam · NL

Funding

National Health ServiceNational Institute of Health Research
6 · The paper itself

Abstract

introductionThe prognostic value of histomorphologic regression in primary esophageal cancer has been previously established, however the impact of lymph node (LN) response on survival still remains unclear. The aim of this review was to assess the prognostic significance of LN regression or downstaging following neoadjuvant therapy for esophageal cancer.

methodsAn electronic search was performed to identify articles evaluating LN regression or downstaging after neoadjuvant therapy. Random effects meta-analyses were performed to assess the influence of regression in the LNs and nodal downstaging on overall survival. Histomorphologic tumor regression in LNs was defined by the absence of viable cells or degree of fibrosis on histopathologic examination. Downstaged LNs were defined as pN0 nodes by the tumor, node, and metastasis classification, which were positive prior to treatment neoadjuvant.

resultsEight articles were included, three of which assessed tumor regression (number of patients = 292) and five assessed downstaging (number of patients = 1368). Complete tumor regression (average rate of 29.1%) in the LNs was associated with improved survival, although not statistically significant (hazard ratio [HR] = 0.52, 95% confidence interval [CI] = 0.26-1.06; P = 0.17). LNs downstaging (average rate of 32.2%) was associated with improved survival compared to node positivity after neoadjuvant treatment (HR = 0.41, 95%CI = 0.22-0.77; P = 0.005). DISCUSSION: The findings of this meta-analysis have shown a survival benefit in patients with LN downstaging and are suggestive for considering LN downstaging to ypN0 as an additional prognostic marker in staging and in the comparative evaluation of differing neoadjuvant regimens in clinical trials. No statistically significant effect of histopathologic regression in the LNs on long-term survival was seen.

Indexed as

Esophageal NeoplasmsHumansLymphatic MetastasisLymph Node ExcisionLymph NodesNeoadjuvant TherapyNeoplasm StagingPrognosisRetrospective Studiesesophageal cancerlymph node regressionneoadjuvant therapy

Identifiers

PMID33893494
PMCPMC8752080
OpenAlexW3154319436

What OpenQuestion holds

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LicenceCC BY
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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.