Evidence map›Paper›PMID 34988688›Full record

ArticleJournal of gastroenterology2022

Surgical results of non-ampullary duodenal cancer: a nationwide survey in Japan.

Kenji Nakagawa, Masayuki Sho, Ken-Ichi Okada, Takahiro Akahori, Toru Aoyama, Hidetoshi Eguchi, Tsutomu Fujii, Ryota Higuchi, Shingo Kanaji, Kengo Kanetaka and 8 more

Abstract read
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In one paragraph

Article in Journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 4 pooled it
3.3field-weighted citation impact, top 7% 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

21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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  6. Muir-Torre syndrome in a patient with advanced duodenal carcinoma.Clinical journal of gastroenterology · 2026
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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 14 institutions in 1 country.

Kenji NakagawaDepartment of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Masayuki ShoDepartment of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. m-sho@naramed-u.ac.jp.
Ken-Ichi OkadaSecond Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.
Takahiro AkahoriDepartment of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Toru AoyamaDepartment of Surgery, Yokohama City University, Yokohama, Japan.
Hidetoshi EguchiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Tsutomu FujiiDepartment of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
Ryota HiguchiDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Shingo KanajiDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan.
Kengo KanetakaDepartment of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Shinji KurodaDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
Yuichi NagakawaDepartment of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Souya NunobeDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan.
Suguru YamadaDepartment of Gastroenterological Surgery, Nagoya Central Hospital, Nagoya, Japan.
Hiroharu YamashitaDepartment of Gastrointestinal Surgery, Nihon University Hospital, Tokyo, Japan.
Hiroki YamaueSecond Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.
Yasuhiro KoderaDepartment of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
Japan Duodenal Cancer Guideline Committee
Nara Medical University · JPWakayama Medical University · JPKobe University · JPNagasaki University · JPNagoya Central Hospital · JPNagoya University · JPNihon University · JPOkayama University · JPOsaka University · JPThe Cancer Institute Hospital · JPTokyo Medical University · JPTokyo Women's Medical University · JPUniversity of Toyama · JPYokohama City University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs non-ampullary duodenal cancer is relatively rare, the optimal treatment strategy, including the appropriate surgical procedure and efficacy of adjuvant chemotherapy, remains unclear. This nationwide survey aimed to clarify the actual lymph node spread pattern and determine the optimal treatment strategy for this disease, using a large-scale database.

methodsWe used a questionnaire and a retrospective registry of 1083 patients with non-ampullary duodenal cancer who had undergone surgery during 2008-2017 in 114 high-volume Japanese Society of Hepatobiliary and Pancreatic Surgery-certified training institutions. Propensity score-matched analyses were conducted to minimise background bias. Cox regression was performed to identify covariates associated with recurrence-free survival. There were distinct disparities in the nodal dissection rate according to the predominant tumor location and tumor invasion depth. Metastases were frequently observed in the peripancreatic nodes and those along the superior mesenteric artery, irrespective of tumor location. Their dissection seemed to be beneficial for improved survival. In the overall cohort, no survival benefit was observed in patients who received adjuvant chemotherapy when compared with that in patients who underwent surgery alone. Nevertheless, in the matched cohort, adjuvant chemotherapy for > 6 months was associated with a significant improvement in recurrence-free survival (median: 43.5 vs. 22.5 months, p = 0.016), particularly in patients with tumor invasion of the subserosa or deeper tumor invasion, lymph node metastasis, or elevated serum carbohydrate antigen 19-9 levels.

conclusionPancreatoduodenectomy should be the standard procedure for advanced non-ampullary duodenal cancer. Adjuvant chemotherapy for > 6 months, especially for advanced tumors, significantly improves survival.

Indexed as

AdenocarcinomaDuodenal NeoplasmsChemotherapy, AdjuvantHumansJapanNeoplasm StagingRetrospective StudiesSurveys and QuestionnairesAdjuvant chemotherapyDuodenal cancerPancreatoduodenectomy

Identifiers

PMID34988688
OpenAlexW4206651782

What OpenQuestion holds

Textmetadata
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.