Evidence map›Paper›PMID 36434481›Full record

ArticleAnnals of surgical oncology2023

Calcifications and Cystic Morphology on Preoperative Imaging Predict Survival After Resection of Pancreatic Neuroendocrine Tumors.

Eleftherios A Makris, John G Douglas Cannon, Jeffrey A Norton, Alexandra G Lopez-Aguiar, Mary Dillhoff, Eliza Beal, Kamran Idrees, Paula Marincola Smith, Flavio G Rocha, Zaheer Kanji and 8 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2023. 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
0.8field-weighted citation impact, top 28% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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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 8 institutions in 1 country.

Eleftherios A MakrisSection of Surgical Oncology, Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
John G Douglas CannonSection of Surgical Oncology, Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
Jeffrey A NortonSection of Surgical Oncology, Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
Alexandra G Lopez-AguiarDepartment of Surgery, Emory University, Atlanta, GA, USA.
Mary DillhoffDepartment of Surgery, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Eliza BealDepartment of Surgery, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
Kamran IdreesDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Paula Marincola SmithDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Flavio G RochaDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
Zaheer KanjiDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
Clifford ChoDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Megan BeemsDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA.
Sharon WeberDepartment of Surgery, University of Wisconsin, Madison, WI, USA.
Alexander FisherDepartment of Surgery, University of Wisconsin, Madison, WI, USA.
Bradley A KrasnickDepartment of Surgery, Washington University, St Louis, MO, USA.
Ryan C FieldsDepartment of Surgery, Washington University, St Louis, MO, USA.
Shishir K MaithelDepartment of Surgery, Emory University, Atlanta, GA, USA.
George A PoultsidesSection of Surgical Oncology, Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA. gpoultsides@stanford.edu.
Stanford University · USEmory University · USThe Ohio State University · USUniversity of Michigan–Ann Arbor · USUniversity of Wisconsin–Madison · USVanderbilt University Medical Center · USVirginia Mason Medical Center · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadiographic calcifications and cystic morphology are associated with higher and lower tumor grade, respectively, in pancreatic neuroendocrine tumors (PNETs). Whether calcifications and/or cystic morphology could be used preoperatively to predict post-resection survival in patients with PNETs remains elusive.

methodsPatients undergoing curative-intent resection of well-differentiated PNETs from 2000 to 2017 at eight academic institutions participating in the US Neuroendocrine Tumor Study Group were identified. Preoperative cross-sectional imaging reports were reviewed to identify the presence of calcifications and of a cystic component occupying >50% of the total tumor area. Clinicopathologic characteristics and recurrence-free survival (RFS) were compared.

resultsOf 981 patients studied, 18% had calcifications and 17% had cystic tumors. Tumors with calcifications were more commonly associated with Ki-67 ≥3% (47% vs. 33%; p = 0.029), lymph node metastasis (36% vs. 24%; p = 0.011), and distant metastasis (13% vs. 4%; p < 0.001). In contrast, cystic tumors were less commonly associated with lymph node metastasis (12% vs. 30%; p < 0.001). Five-year RFS after resection was most favorable for cystic tumors without calcifications (91%), intermediate for solid tumors without calcifications (77%), and least favorable for any calcified PNET (solid 69%, cystic 67%; p = 0.043). Calcifications remained an independent predictor of RFS on multivariable analysis (p = 0.043) controlling for nodal (p < 0.001) and distant metastasis (p = 0.001).

conclusionsEasily detectable radiographic features, such as calcifications and cystic morphology, can be used preoperatively to stratify prognosis in patients with PNETs and possibly inform the decision to operate or not, as well as guide the extent of resection and potential use of neoadjuvant therapy.

Indexed as

CalcinosisNeuroectodermal Tumors, PrimitiveNeuroendocrine TumorsPancreatic NeoplasmsHumansLymphatic MetastasisPancreatectomyRetrospective Studies

Identifiers

PMID36434481
OpenAlexW4310045191

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.