Evidence map›Paper›PMID 34132929›Full record

ArticleInternational journal of clinical oncology2021

Surgical margin clearance and extended chemotherapy defines survival for synchronous oligometastatic liver lesions of the ductal adenocarcinoma of the pancreas.

S A Safi, G Fluegen, A Rehders, L Haeberle, S Fung, V Keitel, A Krieg, W T Knoefel, N Lehwald-Tywuschik

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Article in International journal of clinical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
–field-weighted citation impact
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

10 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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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

9 authors.

S A SafiDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.ORCID http://orcid.org/0000-0002-9874-9225
G FluegenDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
A RehdersDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
L HaeberleInstitute of Pathology, Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Dusseldorf, Germany.
S FungDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
V KeitelDepartment of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Dusseldorf, Germany.
A KriegDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.
W T KnoefelDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany. knoefel@hhu.de.
N Lehwald-TywuschikDepartment of Surgery (A), Medical Faculty, Heinrich-Heine-University and University Hospital Dusseldorf, Moorenstr. 5, 40225, Dusseldorf, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of surgery for circumscribed synchronous hepatic lesions of the pancreatic ductal adenocarcinoma (PDAC) remains controversial. Thus, the aim of our study was to compare survival outcome (OS) after surgery of patients with hepatic metastases (M1surg) to patients with only localized disease.

methodsCorrelation analysis of clinicopathological data and OS after resection of M1surg patients and patients with localized PDACs (M0) was performed. Patients were included for survival analysis only if a complete staging including perineural, venous and lymphatic invasion was available.

resultsOut of the study collective, 35 patients received extended surgery (M1surg), whereas 131 patients received standardized surgery for localized disease (M0). Length of hospitalization and mortality was similar in both groups. FOLFIRNOX as an adjuvant treatment regime was administered in ~ 23 and ~ 8% of M1surg and M0 patients, respectively. In subgroup analysis of R0 resected patients and in multivariate analysis of the total cohort, there was no difference in overall survival between both groups. Only the resection status (R1 vs R0) and venous invasion (V1) were identified as independent prognostic factors. Site of recurrence in R0 resected M1surg patients and in M0 patients were homogenously distributed.

conclusionThis is the first study demonstrating a survival benefit after extended surgery for synchronously hepatic-metastasized PDACs. We found no difference in survival outcome of metastasized patients when compared to patients with localized disease. FOLFIRINOX as an adjuvant treatment regime for resected M1surg presumably is worthwhile. Larger multicenter studies are still needed to validate our results.

Indexed as

Carcinoma, Pancreatic DuctalLiver NeoplasmsPancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsFemaleHumansMargins of ExcisionNeoplasm Recurrence, LocalPancreasPancreatectomyDuctal adenocarcinoma of the pancreasHepatic metastasesOligometastaticPDACSurvival outcome

Identifiers

PMID34132929
PMCPMC8449759

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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.