Evidence map›Paper›PMID 36163566›Full record

ArticleSurgical endoscopy2023

Robotic approach mitigates the effect of major complications on survival after pancreaticoduodenectomy for periampullary cancer.

Thiagarajan Meyyappan, Greg C Wilson, Herbert J Zeh, Melissa E Hogg, Kenneth K Lee, Amer H Zureikat, Alessandro Paniccia

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

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
1.4field-weighted citation impact, top 17% 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, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
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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

7 authors at 4 institutions in 1 country.

Thiagarajan MeyyappanDivision of Surgical Oncology, University of Pittsburgh Medical Center, 3550 Terrace Street, A425 Scaife Hall, Pittsburgh, PA, 15261, USA.
Greg C WilsonDepartment of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Herbert J ZehDepartment of Surgery, University of Texas Southwestern, Dallas, TX, USA.
Melissa E HoggDepartment of Surgery, NorthShore Hospital, Chicago, IL, USA.
Kenneth K LeeDivision of Surgical Oncology, University of Pittsburgh Medical Center, 3550 Terrace Street, A425 Scaife Hall, Pittsburgh, PA, 15261, USA.
Amer H ZureikatDivision of Surgical Oncology, University of Pittsburgh Medical Center, 3550 Terrace Street, A425 Scaife Hall, Pittsburgh, PA, 15261, USA.
Alessandro PanicciaDivision of Surgical Oncology, University of Pittsburgh Medical Center, 3550 Terrace Street, A425 Scaife Hall, Pittsburgh, PA, 15261, USA. Panicciaa2@upmc.edu.ORCID http://orcid.org/0000-0001-7047-1711
University of Pittsburgh Medical Center · USNorthShore University HealthSystem · USThe University of Texas Southwestern Medical Center · USUniversity of Cincinnati Medical Center · US

Funding

VECTOR CORE FACILITYP30CA047904 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Jessie Nedrow · 1988 to 2026
$158.0M
NCI NIH HHS P30 CA047904
6 · The paper itself

Abstract

backgroundMajor complications (MCs) after pancreaticoduodenectomy (PD) are a known independent predictor of worse oncologic outcomes. There are limited data on the effect of major complications on long-term outcomes after robotic PD (RPD). The aim of this study is to compare the effect of MC on overall (OS) and disease-free survival (DFS) after RPD and open PD (OPD).

methodsThis is a single-center, retrospective review of a prospectively maintained database of all patients undergoing PD for periampullary cancer including ampullary adenocarcinoma, distal cholangiocarcinoma, and duodenal carcinoma. Univariate analysis was performed on all clinical, pathologic, and treatment factors. MCs were defined as Clavien-Dindo ≥ grade 3. Kaplan-Maier survival analysis was performed with log-rank test for group comparison. Multivariable Cox regression analysis was used to identify factors associated with overall survival (OS) in both the OPD and RPD groups.

resultsA total of 190 patients with ampullary carcinoma (n = 98), cholangiocarcinoma (n = 55), and duodenal adenocarcinoma (n = 37) were examined over the study period with 61.1% (n = 116) undergoing RPD and 38.9% (n = 74) undergoing OPD. There was no significant difference in patient demographics between the RPD and OPD cohorts. Furthermore, R0 resection rates, tumor size, and lymph node involvement were similar between the RPD and OPD cohorts. OPD had higher rate of MC (40.5% vs 28.3% in RPD, p = 0.011) including clinically relevant pancreatic fistula (25.7% vs 8.6%, p = 0.001) and wound infection (34.5% vs 13.8%, p < 0.001). MCs were associated with a lower OS in the OPD cohort (HR = 2.18, 95%CI 1.0-4.55, p = 0.038). MCs were not associated with OS in the RPD cohort (HR = 1.55, 95%CI 0.87-2.76, p = 0.14).

conclusionMCs are associated with worse patient outcomes after OPD but not after RPD. Robotic approach mitigates and possibly abrogates the negative effects of MCs on patient outcomes after PD for malignancy and is associated with improved adjuvant chemotherapy completion rates.

Indexed as

AdenocarcinomaBile Duct NeoplasmsCholangiocarcinomaDuodenal NeoplasmsLaparoscopyPancreatic NeoplasmsRobotic Surgical ProceduresBile Ducts, IntrahepaticHumansPancreaticoduodenectomyPostoperative ComplicationsRetrospective StudiesPancreaticoduodenectomyPeriampullary cancerRoboticsWhipple

Identifiers

PMID36163566
PMCPMC11189666
OpenAlexW4297093826

What OpenQuestion holds

Textmetadata
LicenceTDM
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.