Evidence map›Paper›PMID 34950434›Full record

ArticleWorld journal of gastrointestinal surgery2021

Long-term survival of patients with stage II and III gastric cancer who underwent gastrectomy with inadequate nodal assessment.

Jacopo Desiderio, Andrea Sagnotta, Irene Terrenato, Eleonora Garofoli, Claudia Mosillo, Stefano Trastulli, Federica Arteritano, Federico Tozzi, Vito D'Andrea, Yuman Fong and 3 more

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Article in World journal of gastrointestinal surgery, 2021. 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
–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

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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.

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Jacopo DesiderioDepartment of Digestive Surgery, St. Mary's Hospital, Terni 05100, Italy.
Andrea SagnottaDepartment of General Surgery and Surgical Oncology, San Filippo Neri Hospital, Rome 00135, Italy.
Irene TerrenatoBiostatistics and Bioinformatic Unit, Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome 00144, Italy.
Eleonora GarofoliDepartment of Medical Oncology, St. Mary's Hospital, Terni 05100, Italy.
Claudia MosilloDepartment of Medical Oncology, St. Mary's Hospital, Terni 05100, Italy.
Stefano TrastulliDepartment of Digestive Surgery, St. Mary's Hospital, Terni 05100, Italy.
Federica ArteritanoDepartment of Digestive Surgery, St. Mary's Hospital, Terni 05100, Italy.
Federico TozziDivision of Surgical Oncology and Endocrine Surgery, Mays Cancer Center, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, United States.
Vito D'AndreaDepartment of Surgical Sciences, Sapienza University of Rome, Rome 00161, Italy.
Yuman FongDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, LA, 91010, United States.
Yanghee WooDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, LA, 91010, United States.
Sergio BracardaDepartment of Medical Oncology, St. Mary's Hospital, Terni 05100, Italy.
Amilcare ParisiDepartment of Digestive Surgery, St. Mary's Hospital, Terni 05100, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastric cancer is an aggressive disease with frequent lymph node (LN) involvement. The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs. This threshold has been the subject of great debate, not only for the extent of surgery but also for more appropriate staging. The reclassification of stage IIB through IIIC based on N3b nodal staging in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system highlights the efforts to more accurately discriminate survival expectancy based on nodal number. Furthermore, studies have suggested that pathologic assessment of 30 or more LNs improve prognostic accuracy and is required for proper staging of gastric cancer.

aimTo evaluate the long-term survival of advanced gastric cancer patients who deviated from expected survival curves because of inadequate nodal evaluation.

methodsEligible patients were identified from the Surveillance, Epidemiology, and End Results database. Those with stage II-III gastric cancer were considered for inclusion. Three groups were compared based on the number of analyzed LNs. They were inadequate LN assessment (ILA, < 16 LNs), adequate LN assessment (ALA, 16-29 LNs), and optimal LN assessment (OLA, ≥ 30 LNs). The main outcomes were overall survival (OS) and cancer-specific survival. Data were analyzed by the Kaplan-Meier product-limit method, log-rank test, hazard risk, and Cox proportional univariate and multivariate models. Propensity score matching (PSM) was used to compare the ALA and OLA groups.

resultsThe analysis included 11607 patients. Most had advanced T stages (T3 = 48%; T4 = 42%). The pathological AJCC stage distribution was IIA = 22%, IIB = 18%, IIIA = 26%, IIIB = 22%, and IIIC = 12%. The overall sample divided by the study objective included ILA (50%), ALA (35%), and OLA (15%). Median OS was 24 mo for the ILA group, 29 mo for the ALA group, and 34 mo for the OLA group (

conclusionProper nodal staging is a critical issue in gastric cancer. Assessment of an inadequate number of LNs places patients at high risk of adverse long-term survival outcomes.

Indexed as

GastrectomyGastric CancerLymphadenectomyN stageStagingSurveillance, Epidemiology, and End Results

Identifiers

PMID34950434
PMCPMC8649557

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