Evidence map›Paper›PMID 34664190›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022

Neoadjuvant Chemotherapy Versus Upfront Surgery for Resectable Liver Metastases from Colorectal Cancer: a Multicenter, Propensity Score-Matched Cohort Study.

Fumitoshi Hirokawa, Masaki Ueno, Takuya Nakai, Masaki Kaibori, Takeo Nomi, Hiroya Iida, Shogo Tanaka, Koji Komeda, Shinya Hayami, Hisashi Kosaka and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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, 2 syntheses or guidelines pooled it.

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

13 authors.

Fumitoshi HirokawaDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. sur122@osaka-med.ac.jp.ORCID http://orcid.org/0000-0002-7829-6644
Masaki UenoSecond Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Takuya NakaiDepartment of Surgery, Faculty of Medicine, Kinki University, Osaka-Sayama, Japan.
Masaki KaiboriDepartment of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
Takeo NomiDepartment of Surgery, Nara Medical University, Kashihara, Japan.
Hiroya IidaDepartment of Surgery, Shiga University of Medical Science, Otsu, Japan.
Shogo TanakaDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Koji KomedaDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Shinya HayamiSecond Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Hisashi KosakaDepartment of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
Daisuke HokutoDepartment of Surgery, Nara Medical University, Kashihara, Japan.
Shoji KuboDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Kazuhisa UchiyamaDepartment of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdjuvant chemotherapy for resectable colorectal liver metastasis (CRLM) is widely used, but its efficacy lacks clear evidence. This retrospective cohort study investigated the effectiveness of neoadjuvant chemotherapy (NAC) compared to upfront surgery for CRLM.

methodsData from patients with resectable CRLM were analyzed. Short-term outcomes and long-term prognosis were analyzed using propensity score matching. CRLM was stratified according to the H-classification (H1 and H2), and the effectiveness of adjuvant chemotherapy was analyzed in each group.

resultsWe analyzed 599 cases that were matched into an NAC group (n = 136) and an upfront surgery group (n = 136). The proportion of synchronous metastases, H2-classification, and postoperative chemotherapy rate did not differ between the groups. Overall survival (OS) after initial treatment was significantly worse in the NAC group than in the upfront surgery group (P = 0.029). The 5-, 7-, and 10-year OS rates for H1 patients were significantly better in the upfront surgery group than in the NAC group (64%, 51%, and 44% vs. 50%, 31%, and 18%, respectively) (P = 0.004).

conclusionPatients with resectable CRLM should undergo upfront surgery, because NAC did not improve OS after initial treatment in these patients.

Indexed as

Colorectal NeoplasmsLiver NeoplasmsChemotherapy, AdjuvantCohort StudiesHepatectomyHumansNeoadjuvant TherapyPropensity ScoreRetrospective StudiesColorectal cancerHepatectomyLiverMetastasisNeoadjuvant chemotherapy

Identifiers

PMID34664190

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.