Evidence map›Paper›PMID 34838082›Full record

ArticleDiagnostic pathology2021

Clinicopathologic correlations of superficial esophageal adenocarcinoma in endoscopic submucosal dissection specimens.

Sadhna Dhingra, Firas Bahdi, Sarah B May, Mohamed O Othman

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

Article in Diagnostic pathology, 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
1.8field-weighted citation impact, top 14% 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, 14 citations in OpenAlex.

  1. Clinical practice guidelines for esophagogastric junction cancer: Upper GI Oncology Summit 2023.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024
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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

4 authors at 1 institution in 1 country.

Sadhna DhingraFormerly, Department of Pathology and Immunology, Baylor College of Medicine, One Baylor Plaza, BCM 315, Houston, Texas 77030. Currently, ProPath Laboratories, River Bend Drive, Dallas, TX, 75247, USA. Sadhna.Dhingra@ProPath.com.ORCID http://orcid.org/0000-0003-0436-033X
Firas BahdiMargaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, McNair Campus 7200 Cambridge Street 8th Floor, Houston, TX, 77030, USA.
Sarah B MayMargaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, McNair Campus 7200 Cambridge Street 8th Floor, Houston, TX, 77030, USA.
Mohamed O OthmanDivision of Gastroenterology, Baylor College of Medicine, Margaret M. and Albert B. Alkek Department of Medicine, McNair Campus 7200 Cambridge Street 8th Floor, Houston, TX, 77030, USA.
Baylor College of Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic submucosal dissection (ESD) is a novel endoscopic treatment for early esophageal adenocarcinoma (EAC). The western pathologists' experience with ESD specimens remains limited. This study aimed to correlate histopathologic features of Barrett's esophagus (BE)-associated adenocarcinoma in ESD resections with clinical outcomes to determine whether they aid future management decisions.

methodsWe retrospectively evaluated 49 consecutive ESD resection specimens from 42 patients with BE-associated adenocarcinoma (24 intramucosal and 18 submucosal EAC) at a single tertiary referral center. Pathologic evaluation included presence of dysplasia, invasive adenocarcinoma, peritumoral inflammation, desmoplasia, lymphovascular and perineural invasion; tumor differentiation, depth of invasion, morphology, and budding; and margin status for dysplasia or carcinoma. Follow up data included endoscopic biopsies in 35 patients and pathology reports of esophagectomies in 11 patients. Poor outcomes were defined as recurrence or residual invasive adenocarcinoma at esophagectomy, metastasis on imaging, or R1 resection in patients undergoing ESD for tumor debulking.

resultsTwo patients (8%) with intramucosal adenocarcinoma and 9 patients (50%) with submucosal adenocarcinoma had poor outcomes. Histopathologic features associated with poor outcomes included poor differentiation, lymphovascular invasion, submucosal invasion > 500 μm, tumor budding, and tubuloinfiltrative histologic pattern. Four patients had positive deep margin away from the deepest tumor invasion and did not show residual tumor on follow up.

conclusionsOur results validated European Society of Gastroenterology (ESGE) guidelines of high-risk pathologic features for additional therapy in esophageal adenocarcinoma and identified tumor budding frequently in association with other high-risk features. Positive deep margin distant from deepest tumor invasion could be procedural and warrants endoscopic correlation for management.

Indexed as

Endoscopic Mucosal ResectionEsophagectomyAdenocarcinomaAgedAged, 80 and overBarrett EsophagusBiopsyEsophageal NeoplasmsFemaleHumansMaleMargins of ExcisionMiddle AgedNeoplasm InvasivenessNeoplasm Recurrence, LocalPredictive Value of TestsBarrett’s esophagusEndoscopic submucosal dissectionMucosal adenocarcinomaSubmucosal adenocarcinomaTumor budding

Identifiers

PMID34838082
PMCPMC8627628
OpenAlexW3215378195

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.