Evidence map›Paper›PMID 34480285›Full record

ArticleAnnals of surgical oncology2022

Neoadjuvant versus Postoperative Chemoradiotherapy is Associated with Improved Survival for Patients with Resectable Gastric and Gastroesophageal Cancer.

Daniel W Kim, Grace Lee, Theodore S Hong, Guichao Li, Nora K Horick, Eric Roeland, Florence K Keane, Christine Eyler, Lorraine C Drapek, David P Ryan and 7 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 27% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. 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

17 authors at 3 institutions in 2 countries.

Daniel W KimDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Grace LeeDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Theodore S HongDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Guichao LiDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Nora K HorickMassachusetts General Hospital Biostatistics Center, Boston, MA, USA.
Eric RoelandDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Florence K KeaneDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Christine EylerDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
Lorraine C DrapekDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA.
David P RyanDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Jill N AllenDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
David BergerDepartment of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Aparna R ParikhDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
John T MullenDepartment of Surgical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Sam J KlempnerDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Jeffrey W ClarkDepartment of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.
Jennifer Y WoDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA. jwo@mgh.harvard.edu.
Massachusetts General Hospital · USFudan University Shanghai Cancer Center · CNHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal timing of chemoradiotherapy (CRT) for patients with localized gastric cancer remains unclear. This study aimed to compare the survival outcomes between neoadjuvant and postoperative CRT for patients with gastric and gastroesophageal junction (GEJ) cancer.

methodsThis retrospective study analyzed 152 patients with gastric (42%) or GEJ (58%) adenocarcinoma who underwent definitive surgical resection and received either neoadjuvant or postoperative CRT between 2005 and 2017 at the authors' institution. The primary end point of the study was overall survival (OS).

resultsThe median follow-up period was 37.5 months. Neoadjuvant CRT was performed for 102 patients (67%) and postoperative CRT for 50 patients (33%). The patients who received neoadjuvant CRT were more likely to be male and to have a GEJ tumor, positive lymph nodes, and a higher clinical stage. The median radiotherapy (RT) dose was 50.4 Gy for neoadjuvant RT and 45.0 Gy for postoperative RT (p < 0.001). The neoadjuvant CRT group had a pathologic complete response (pCR) rate of 26% and a greater rate of R0 resection than the postoperative CRT group (95% vs. 76%; p = 0.002). Neoadjuvant versus postoperative CRT was associated with a lower rate of any grade 3+ toxicity (10% vs. 54%; p < 0.001). The multivariable analysis of OS showed lower hazards of death to be independently associated neoadjuvant versus postoperative CRT (hazard ratio [HR] 0.57; 95% confidence interval [CI] 0.36-0.91; p = 0.020) and R0 resection (HR 0.50; 95% CI 0.27-0.90; p = 0.021).

conclusionsNeoadjuvant CRT was associated with a longer OS, a higher rate of R0 resection, and a lower treatment-related toxicity than postoperative CRT. The findings suggest that neoadjuvant CRT is superior to postoperative CRT in the treatment of gastric and GEJ cancer.

Indexed as

Esophageal NeoplasmsStomach NeoplasmsChemoradiotherapyFemaleHumansMaleNeoadjuvant TherapyRetrospective StudiesChemoradiotherapyGastric cancerGastroesophageal cancerNeoadjuvantPostoperativeSurvival

Identifiers

PMID34480285
OpenAlexW3197425968

What OpenQuestion holds

Textmetadata
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.