Evidence map›Paper›PMID 34379324›Full record

ArticleJournal of surgical oncology2021

Attrition during neoadjuvant chemotherapy for gastric adenocarcinoma is associated with decreased survival: A United States Safety-Net Collaborative analysis.

Joshua P Kronenfeld, Amber L Collier, Michael K Turgeon, Michelle Ju, Rodrigo Alterio, Annie Wang, Manuel Fernandez, Matthew R Porembka, Harry Richter, Ann Y Lee and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
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 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.9field-weighted citation impact, top 25% 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

7 citing papers in PubMed, 9 citations in OpenAlex.

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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

14 authors at 6 institutions in 1 country.

Joshua P KronenfeldDivision of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.ORCID http://orcid.org/0000-0003-4540-3658
Amber L CollierDivision of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.ORCID https://orcid.org/0000-0002-5238-227X
Michael K TurgeonDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0001-7197-9007
Michelle JuDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical School, Dallas, Texas, USA.ORCID https://orcid.org/0000-0003-0920-7617
Rodrigo AlterioDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical School, Dallas, Texas, USA.ORCID https://orcid.org/0000-0002-2620-7494
Annie WangDivision of Surgical Oncology, Department of Surgery, NYU Langone Health, New York, New York, USA.
Manuel FernandezDivision of Surgical Oncology, Department of Surgery, University of Illinois College of Medicine, Chicago, Illinois, USA.
Matthew R PorembkaDivision of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical School, Dallas, Texas, USA.ORCID https://orcid.org/0000-0003-1596-0058
Harry RichterDivision of Surgical Oncology, Department of Surgery, University of Illinois College of Medicine, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0001-5849-3870
Ann Y LeeDivision of Surgical Oncology, Department of Surgery, NYU Langone Health, New York, New York, USA.
Maria C RussellDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0003-1584-6992
Nipun B MerchantDivision of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.ORCID https://orcid.org/0000-0002-3399-9776
Ajay V MakerDivision of Surgical Oncology, Department of Surgery, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-8234-2762
Jashodeep DattaDivision of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.ORCID https://orcid.org/0000-0003-2869-1571
University of Miami · USThe University of Texas Southwestern Medical Center · USEmory University · USNYU Langone Health · USUniversity of Illinois Urbana-Champaign · USUniversity of California, San Francisco · US

Funding

Research Training Program in Surgical OncologyT32CA211034 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI MERCHANT, NIPUN B. · 2016 to 2025
$2.7M
NCI NIH HHS T32 CA211034NCI NIH HHS T32CA211034
6 · The paper itself

Abstract

backgroundNeoadjuvant chemotherapy (NAC) is standard management for localized gastric cancer (GC). Attrition during NAC due to treatment-related toxicity or functional decline is considered a surrogate for worse biologic outcomes; however, data supporting this paradigm are lacking. We investigated factors predicting attrition and its association with overall survival (OS) in GC.

methodsPatients with nonmetastatic GC initiating NAC were identified from the US Safety-Net Collaborative (2012-2014). Patient/treatment-related characteristics were compared between attrition/nonattrition cohorts. Cox models determined factors associated with OS.

resultsOf 116 patients initiating NAC, attrition during prescribed NAC occurred in 24%. No differences were observed in performance status, comorbidities, treatment at safety-net hospital, or clinicopathologic factors between cohorts. Despite absence of distinguishing factors, attrition was associated with worse OS (median: 11 vs. 37 months; p = 0.01) and was an independent predictor of mortality (hazard ratio [HR]: 4.7, 95% confidence interval [CI]: 1.5-15.2; p = 0.02). Fewer patients with attrition underwent curative-intent surgery (39% vs. 89%; p < 0.001). Even in patients undergoing surgical exploration (n = 89), NAC attrition remained an independent predictor of worse OS (HR: 50.8, 95% CI: 3.6-717.8; p = 0.004) despite similar receipt of adjuvant chemotherapy.

conclusionAttrition during NAC for nonmetastatic GC is independently associated with worse OS, even in patients undergoing surgery. Attrition during NAC may reflect unfavorable tumor biology not captured by conventional staging metrics.

Indexed as

Activities of Daily LivingAdenocarcinomaAdolescentAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoadjuvant TherapyPrognosisRetrospective StudiesStomach Neoplasmscompletion of therapygastric cancerneoadjuvant therapy

Identifiers

PMID34379324
PMCPMC8595640
OpenAlexW3192971409

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.