Evidence map›Paper›PMID 35074322›Full record

Trial reportJournal of geriatric oncology2022

Effects of a perioperative geriatric intervention for older adults with Cancer: A randomized clinical trial.

Ryan D Nipp, Carolyn L Qian, Helen P Knight, Cristina R Ferrone, Hiroko Kunitake, Carlos Fernandez-Del Castillo, Michael Lanuti, Motaz Qadan, Rocco Ricciardi, Keith D Lillemoe and 13 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of geriatric oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
3.9field-weighted citation impact, top 6% 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

23 citing papers in PubMed, 37 citations in OpenAlex.

  1. Trial
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  18. Observational
  19. Challenges in Geriatric Oncology-A Surgeon's Perspective.Current oncology (Toronto, Ont.) · 2022
    Review
  20. From Assessment to Implementation and Beyond in Cancer and Aging Research.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
    Review
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

23 authors at 6 institutions in 1 country.

Ryan D NippDepartment of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA. Electronic address: rnipp@mgh.harvard.edu.
Carolyn L QianDepartment of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Helen P KnightDepartment of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA.
Cristina R FerroneDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Hiroko KunitakeDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Carlos Fernandez-Del CastilloDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Michael LanutiDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Motaz QadanDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Rocco RicciardiDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Keith D LillemoeDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Brandon TemelDepartment of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Ardeshir Z HashmiDepartment of Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, OH, USA.
Erin ScottDepartment of Internal Medicine, Division of Palliative Medicine, Ohio State University, Columbus, OH, USA.
Erin StevensDepartment of Internal Medicine, Division of Palliative Medicine, Ohio State University, Columbus, OH, USA.
Grant R WilliamsDepartment of Medicine, Division of Hematology & Oncology, The University of Alabama at Birmingham, Birmingham, AL, USA.
Zhi Ven FongDepartment of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Terrence A O'MalleyDepartment of Medicine, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Esteban Franco-GarciaDepartment of Medicine, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Nora K HorickBiostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
Vicki A JacksonDepartment of Medicine, Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Joseph A GreerDepartment of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Areej El-JawahriDepartment of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Jennifer S TemelDepartment of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Massachusetts General Hospital · USHarvard University · USThe Ohio State University · USBrigham and Women's Hospital · USCleveland Clinic · USUniversity of Alabama at Birmingham · US

Funding

Myopenia and Mechanisms of Chemotherapy Toxicity in Older Adults with Colorectal Cancer: The M&M StudyK08CA234225 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WILLIAMS, GRANT R · 2018 to 2022
$1.0M
Optimizing Palliative and End of Life Care for Patients with CancerK24CA181253 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI TEMEL, JENNIFER SUE · 2014 to 2018
$737k
NCI NIH HHS K08 CA234225NCI NIH HHS K24 CA181253
6 · The paper itself

Abstract

backgroundOlder adults with gastrointestinal cancers undergoing surgery often experience poor outcomes, such as prolonged postoperative hospital length of stay (LOS), intensive care unit (ICU) use, hospital readmissions, and complications. Involvement of geriatricians in the care of older adults with cancer can improve outcomes. We conducted a randomized trial of a perioperative geriatric intervention (PERI-OP) in older patients with gastrointestinal cancer undergoing surgery.

methodsFrom 9/2016-4/2019, we randomly assigned patients age ≥ 65 with gastrointestinal cancer planning to undergo surgical resection to receive PERI-OP or usual care. Patients assigned to PERI-OP met with a geriatrician preoperatively in the outpatient setting and postoperatively as an inpatient consultant. The primary outcome was postoperative hospital LOS. Secondary outcomes included postoperative ICU use, 90-day hospital readmission rates, and complication rates. We conducted intention-to-treat (ITT) and per-protocol (PP) analyses.

resultsITT analyses included 137/160 patients who underwent surgery (usual care = 68/78, intervention = 69/82). PP analyses included the 68 usual care patients and the 30/69 intervention patients who received the preoperative and postoperative intervention components. ITT analyses demonstrated no significant differences between intervention and usual care in postoperative hospital LOS (7.23 vs 8.21 days, P = 0.374), ICU use (23.2% vs 32.4%, P = 0.257), 90-day hospital readmission rates (21.7% vs 25.0%, P = 0.690), or complication rates (17.4% vs 20.6%, P = 0.668). In PP analyses, intervention patients had shorter postoperative hospital LOS (5.90 vs 8.21 days, P = 0.024), but differences in ICU use (13.3% vs 32.4%, P = 0.081), 90-day hospital readmission rates (16.7% vs 25.0%, P = 0.439), and complication rates (6.7% vs 20.6%, P = 0.137) remained non-significant.

conclusionsIn this randomized trial, PERI-OP did not have a significant impact on postoperative hospital LOS, ICU use, hospital readmissions, or complications. However, the subgroup who received PERI-OP as planned experienced encouraging results. Future studies of PERI-OP should include efforts, such as telehealth, to ensure the intervention is delivered as planned.

Indexed as

NeoplasmsPatient ReadmissionAgedHumansLength of StayPostoperative ComplicationsCancerGeriatric oncologyHealth care deliveryPerioperative careRandomized controlled trialSurgical oncology

Identifiers

PMID35074322
PMCPMC9058195
OpenAlexW4205175514

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.