Evidence map›Paper›PMID 34536115›Full record

ArticleInternational journal of colorectal disease2021

Surgical management of splenic flexure colon cancer: a retrospective propensity-matched study comparing open and minimally invasive approaches using the national cancer database.

Michael L Horsey, Andrew D Sparks, Debra Lai, Aalap Herur-Raman, Matthew Ng, Vincent Obias

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In one paragraph

Article in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% 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, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. 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

6 authors at 3 institutions in 1 country.

Michael L HorseyWalter Reed National Military Medical Center, Bethesda, MD, USA. michael.horsey1@gmail.com.ORCID http://orcid.org/0000-0002-0939-3539
Andrew D SparksDepartment of Surgery, George Washington University Medical Faculty Associates, Washington, DC, USA.
Debra LaiDepartment of Surgery, George Washington University Hospital, Washington, DC, USA.
Aalap Herur-RamanGeorge Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Matthew NgDepartment of Colon and Rectal Surgery, George Washington University Hospital, Washington, DC, USA.
Vincent ObiasDepartment of Colon and Rectal Surgery, George Washington University Hospital, Washington, DC, USA.
George Washington University Hospital · USGeorge Washington University · USWalter Reed National Military Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMinimally invasive resection of colon cancer at the splenic flexure can be technically challenging with concerns for a suboptimal oncologic outcome. We aimed to compare open and minimally invasive approaches following curative resection.

methodsThe National Cancer Database was queried for patients with non-metastatic colon adenocarcinoma at the splenic flexure who underwent resection from 2010 to 2016. Cohorts were separated into open and minimally invasive approaches, and demographic and clinicopathologic variables were compared. Propensity-score matching (PSM) was utilized to balance potential confounding covariates between cohorts to elucidate the independent association between surgical approach and outcomes. Kaplan-Meier estimation and Cox-proportional hazards regression were used to analyze survival. Secondary outcomes were analyzed by way of logistic regression or Mann-Whitney U test.

resultsAfter matching, 842 patients were compared between approaches. Patients who underwent minimally invasive surgery had no significant difference in regional nodes ≥ 12 examined, positive margins, negative circumferential margins, unplanned 30-day readmission, or time from surgery to initiation of chemotherapy when compared to patients who underwent open surgery. Minimally invasive surgery was significantly associated with decreased odds of 30-day mortality, 90-day mortality, and decreased mortality hazard for 5-year overall survival compared to open surgery.

conclusionThe optimal approach for surgical management of splenic flexure colon cancer has not been standardized given its rarity and exclusion from randomized controlled trials. Our retrospective review suggests that minimally invasive resection of splenic flexure colon cancers in carefully selected patients is associated with equivalent oncologic outcomes as well as improved short and long-term survival compared to an open approach.

Indexed as

Colonic NeoplasmsColon, TransverseLaparoscopyRobotic Surgical ProceduresHumansMinimally Invasive Surgical ProceduresRetrospective StudiesTreatment OutcomeColon cancerLaparoscopySplenic flexure cancerSurgery

Identifiers

PMID34536115
OpenAlexW3200860192

What OpenQuestion holds

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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.