Evidence map›Paper›PMID 34651445›Full record

ArticleThoracic cancer2021

Trimodality therapy for esophageal cancer: The role of surgical and radiation treatment parameters in the development of anastomotic complications.

Salem Alfaifi, Robert Chu, Xuan Hui, Stephen Broderick, Craig Hooker, Malcolm Brock, Errol Bush, Russell Hales, Lori Anderson, Jeffrey Hoff and 8 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thoracic cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 26% 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

5 citing papers in PubMed, 6 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

18 authors at 1 institution in 1 country.

Salem AlfaifiDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0002-3981-6053
Robert ChuDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Xuan HuiDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Stephen BroderickDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Craig HookerDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Malcolm BrockDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Errol BushDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Russell HalesDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Lori AndersonDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Jeffrey HoffDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Cole FriedesDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Sarah Han-OhDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Todd McnuttDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Jinny HaDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Stephen YangDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Richard BattafaranoDivision of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Joy FelicianoDepartments of Medical Oncology, Johns Hopkins University, Baltimore, Maryland, USA.
K Ranh VoongDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHere, we investigated the relationship between clinical parameters, including the site of surgical anastomosis and radiation dose to the anastomotic region, and anastomotic complications in esophageal cancer patients treated with trimodality therapy.

methodsBetween 2007 and 2016, esophageal cancer patients treated with trimodality therapy at a tertiary academic cancer center were identified. Patient, treatment, and outcome parameters were collected. Radiation dose to the gastric regions were extracted. Anastomotic complication was defined as leak and/or stricture. We used Fisher's exact and Wilcoxon rank-sum tests to compare the association between clinical parameters and anastomotic complications.

resultsOf 89 patients identified, the median age was 63 years, 82% (n = 73) were male, and 82% had distal (n = 47) or gastroesophageal junction (n = 26) tumors. Median follow-up was 25.8 months. Esophagectomies were performed with cervical (65%, n = 58) or thoracic anastomoses (35%, n = 31). Anastomotic complications developed in 60% (n = 53). Cervical anastomosis was associated with anastomotic complications (83%, n = 44/53, p < 0.01). Radiation to any gastric substructure was not associated with anastomotic complications (p > 0.05). In the subset of patients with distal/gastroesophageal junction tumors undergoing esophagectomy with cervical anastomosis where radiation was delivered to the future neoesophagus, 80% (n = 35/44) developed anastomotic complications. In this high-risk subgroup, radiation was not associated with anastomotic complications (p > 0.05).

conclusionsOur analysis did not demonstrate an association between radiation dose to gastric substructures and anastomotic complications. However, it showed an association between esophagectomy with cervical anastomosis and anastomotic complications. Patients with distal/gastroesophageal junction tumors who undergo esophagectomy with cervical anastomosis have higher rates of anastomotic complications unrelated to radiation to gastric substructures.

Indexed as

AgedAnastomosis, SurgicalAnastomotic LeakCervical VertebraeCombined Modality TherapyEsophageal NeoplasmsEsophagectomyFemaleHumansMaleMiddle AgedNeoadjuvant TherapyPostoperative ComplicationsRetrospective Studiesanastomotic leakanastomotic strictureesophageal cancerneoadjuvant radiationtrimodality therapy

Identifiers

PMID34651445
PMCPMC8636205
OpenAlexW3207248162

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.