Evidence map›Paper›PMID 34245139›Full record

SynthesisCancer reports (Hoboken, N.J.)2021

The importance of time-to-adjuvant treatment on survival with pancreatic cancer: A systematic review and meta-analysis.

Kavin Sugumar, Jonathan J Hue, Solanus De La Serna, Luke D Rothermel, Lee M Ocuin, Jeffrey M Hardacre, John B Ammori, Jordan M Winter

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

Synthesis in Cancer reports (Hoboken, N.J.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
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.

Kavin SugumarDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.ORCID 0000-0002-4311-1312
Jonathan J HueDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.ORCID 0000-0002-1608-8874
Solanus De La SernaCase Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Luke D RothermelDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
Lee M OcuinDepartment of Surgery, Division of Hepatobiliary, Pancreatic Surgery, Atrium Health, Charlotte, North Carolina, USA.ORCID 0000-0003-3341-9521
Jeffrey M HardacreDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
John B AmmoriDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.ORCID 0000-0003-2131-0369
Jordan M WinterDepartment of Surgery, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA.
University Hospitals Seidman Cancer Center · USAtrium Medical Cente · USUniversity School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile adjuvant chemotherapy benefits patients with pancreatic ductal adenocarcinoma (PDAC), the importance of the time to initiation of adjuvant therapy remains unclear.

aimThis study seeks to better understand whether the timing of postoperative chemotherapy initiation affects long-term outcomes in PDAC. METHODS AND

resultsA systematic literature search was performed in Medline, Embase, and Cochrane Library in March 2020. Studies focused on the association between the timing of adjuvant therapy on long-term outcomes in resected PDAC patients were included. The impact of early and delayed therapy as defined by the respective studies was evaluated using forest plot analysis. Overall survival (OS) and disease-free survival (DFS) served as primary endpoints. Out of 3099 published articles, 10 retrospective studies met inclusion criteria. Combined, these studies included clinical data of 13 344 patients. The cut off used to define "early" and "delayed" treatment groups varied in the included studies ranging from 3 to 12 weeks. Due to this heterogeneity, a sub-group analysis of three time cut offs was performed: 3 to 5 weeks, 6 to 8 weeks, and 9 to 12 weeks. There was a significant decrease in OS and DFS when adjuvant therapy was delayed by 3 to 5 weeks after surgery (OS, pooled hazard ratio [HR] = 1.86, 95% confidence interval [CI] = 1.25-2.78; DFS, pooled HR = 1.62, 95% CI = 1.12-2.34). However, due to small sample size and limited studies in this subgroup analysis, the results may be indeterminate. There was no significant decrease in OS with delayed initiation of adjuvant therapy by 6 to 8 weeks and 9 to 12 weeks. Similarly, delay in adjuvant therapy beyond 3-5 weeks.

conclusionsThere was no conclusive evidence suggesting improved survival in patients starting treatment at various time cut offs. Studies investigating the extreme ends of the time-to-treatment spectrum may prove more informative.

Indexed as

Chemotherapy, AdjuvantHumansPancreatic NeoplasmsPrognosisSurvival RateTime-to-Treatmentadjuvant chemotherapydisease-free survivaloverall survivalpancreatic adenocarcinomatime-to-treatment

Identifiers

PMID34245139
PMCPMC8552002
OpenAlexW3181307974

What OpenQuestion holds

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LicenceCC BY
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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.