Evidence map›Paper›PMID 34231222›Full record

ArticleJournal of surgical oncology2021

Optimal management of patients with operable pancreatic head cancer: A Markov decision analysis.

Caroline J Rieser, Sowmya Narayanan, Nathan Bahary, David L Bartlett, Kenneth K Lee, Alessandro Paniccia, Kenneth Smith, Amer H Zureikat

Open access · greenAbstract readCase Reports
In one paragraph

Article in Journal of surgical oncology, 2021. 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
0.3field-weighted citation impact, top 42% 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, 4 citations in OpenAlex.

  1. Surgical management for elderly patients with pancreatic cancer.Annals of surgical treatment and research · 2023
    Review
  2. 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

8 authors at 3 institutions in 1 country.

Caroline J RieserDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID http://orcid.org/0000-0002-4947-6996
Sowmya NarayananDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Nathan BaharyDepartment of Medical Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
David L BartlettAHN Cancer Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Kenneth K LeeDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Alessandro PanicciaDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID http://orcid.org/0000-0001-7047-1711
Kenneth SmithDepartment of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Amer H ZureikatDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
University of Pittsburgh · USAllegheny Health Network · USUniversity of Pittsburgh Medical Center · US

Funding

Postdoctoral Research Training in Biotherapy of CancerT32CA113263 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Udai S Kammula · 2006 to 2026
$3.6M
NCI NIH HHS T32 CA113263NCI NIH HHS T32CA113263
6 · The paper itself

Abstract

introductionNeoadjuvant therapy (NAT) is an emerging strategy for operable pancreatic ductal adenocarcinoma (PDAC). While NAT increases multimodal therapy completion, it risks functional decline and treatment dropout. We used decision analysis to determine optimal management of localized PDAC and consider risks faced by elderly patients.

methodsA Markov cohort decision analysis model evaluated treatment options for a 60-year-old patient with resectable PDAC: (1) upfront pancreaticoduodenectomy or (2) NAT. One-way and probabilistic sensitivity analyses were performed. A subanalysis considered the scenario of a 75-year-old patient.

resultsFor the base case, NAT offered an incremental survival gain of 4.6 months compared with SF (overall survival: 26.3 vs. 21.7 months). In one-way sensitivity analyses, findings were sensitive to recurrence-free survival for NAT patients undergoing adjuvant, probability of completing NAT, and probability of being resectable at exploration after NAT. On probabilistic analysis, NAT was favored in a majority of trials (97%) with a median survival benefit of 5.1 months. In altering the base case for the 75-year-old scenario, NAT had a survival benefit of 3.8 months.

conclusionsThis analysis demonstrates a significant benefit to NAT in patients with localized PDAC. This benefit persists even in the elderly cohort.

Indexed as

Decision Support TechniquesMarkov ChainsAdenocarcinomaAgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalCombined Modality TherapyFollow-Up StudiesHumansMiddle AgedNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsPrognosisRetrospective StudiesSurvival Rateneoadjuvant therapypancreatic cancertheoretical models

Identifiers

PMID34231222
PMCPMC8629568
OpenAlexW3178388419

What OpenQuestion holds

Textmetadata
LicenceTDM
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.