Evidence map›Paper›PMID 36183089›Full record

ArticleBMC surgery2022

Evaluation of additional gastrectomy after noncurative endoscopic submucosal dissection for early gastric cancer.

Shinichiro Makimoto, Yutaka Mushiake, Tomoya Takami, Hiroshi Shintani, Naoki Kataoka, Tomoyuki Yamaguchi, Shoji Oura

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

Article in BMC surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 22% 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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  4. Article
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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 1 institution in 1 country.

Shinichiro MakimotoDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan. shinichirou.makimoto@tokushukai.jp.ORCID http://orcid.org/0000-0001-6650-922X
Yutaka MushiakeDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Tomoya TakamiDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Hiroshi ShintaniDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Naoki KataokaDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Tomoyuki YamaguchiDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Shoji OuraDepartment of Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, 596-8522, Japan.
Kishiwada Tokushukai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforming additional surgery after noncurative endoscopic submucosal dissection (ESD) for early gastric cancer is controversial. Our aims are to clarify the risk factors for lymph node metastasis (LNM) and local residual cancer (RC) after noncurative ESD and to determine recommendations for additional treatment.

methodsOf the 1483 patients who underwent ESD for early gastric cancer between January 2012 and April 2020, we retrospectively analyzed 151 patients diagnosed as having a lesion not meeting the curative criteria after ESD. Of these patients, 100 underwent additional gastrectomy, and 51 were observed without surgery.

resultsSurgical specimens showed LNM in 14 patients (14.0%) and local RC in 7 (7.0%). However, 81 patients (81.0%) had neither of these malignancies. Multivariate analysis revealed that a positive lymphatic invasion (P = 0.035) and an undifferentiated type (P = 0.047) were independent risk factors for LNM, whereas a positive horizontal margin (P = 0.010) was an independent risk factor for local RC. Furthermore, the prevalence of LNM was significantly higher in patients with both positive lymphatic and vascular invasions. In the additional gastrectomy group, 3 patients (3.0%) had recurrences, and 2 patients (2.0%) who had distant recurrences died of gastric cancer. In the observation group, recurrence was observed in 3 patients (5.9%). One patient (2.0%) who had liver metastasis died of gastric cancer. Of the 2 patients (3.9%) who had local recurrences, one underwent additional ESD, and the other without additional ESD died of other disease. The 5-year overall survival rates in the additional gastrectomy and observation groups were 87.4% and 73.8%, respectively (log-rank test, P = 0.008).

conclusionFollowing noncurative ESD for early gastric cancer, we recommend an additional gastrectomy with lymph node dissection for patients with lymphovascular invasion and/or undifferentiated type. Careful follow-ups without additional surgery may be acceptable for patients with advanced age, severe comorbidity, or no lymphovascular invasion.

Indexed as

Endoscopic Mucosal ResectionStomach NeoplasmsGastrectomyGastric MucosaHumansLymphatic MetastasisMargins of ExcisionRetrospective StudiesAdditional gastrectomyEarly gastric cancerEndoscopic submucosal dissectionLocal residual cancerLymph node metastasis

Identifiers

PMID36183089
PMCPMC9526329
OpenAlexW4298622236

What OpenQuestion holds

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LicenceCC BY
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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.