Evidence map›Paper›PMID 36572807›Full record

ArticleAnnals of surgical oncology2023

Impact of Delaying Surgery After Chemoradiation on Outcomes for Locally Advanced Esophageal Squamous Cell Carcinoma.

Lye-Yeng Wong, Douglas Z Liou, Lucas K Vitzthum, Leah M Backhus, Natalie S Lui, Daniel Chang, Joseph B Shrager, Mark F Berry

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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 29% 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

5 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Lye-Yeng WongDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA. wongly@ohsu.edu.ORCID http://orcid.org/0000-0003-1655-7754
Douglas Z LiouDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA.
Lucas K VitzthumDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Leah M BackhusDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA.
Natalie S LuiDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA.
Daniel ChangDepartment of Radiation Oncology, Stanford University, Stanford, CA, USA.
Joseph B ShragerDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA.
Mark F BerryDepartment of Cardiothoracic Surgery, Falk Cardiovascular Research Institute, Stanford University, Stanford, CA, USA.
Cardiovascular Institute of the South · USVA Palo Alto Health Care System · USStanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforming selective esophagectomy for locally advanced squamous cell carcinoma may spare patients morbidity, but delayed surgery may infer higher risks. This study evaluated the impact of length of time between chemoradiation and esophagectomy on perioperative outcomes and long-term survival.

methodsThe impact of surgical timing, stratified by surgery performed < 180 and ≥ 180 days from starting radiation, on perioperative outcomes and survival in patients treated with chemoradiation and esophagectomy for cT1N + M0 and cT2-4, any N, M0 squamous cell carcinoma of the mid-distal esophagus in the National Cancer Database (2006-2016) was evaluated with logistic regression, Kaplan-Meier curves, Cox proportional-hazards methods, and propensity-matched analysis.

resultsMedian time between starting radiation and esophagectomy in 1641 patients was 93 (IQR 81-114) days. Most patients (96.8%, n = 1589) had surgery within 180 days of starting radiation, while 52 patients (3.2%) had delayed surgery. Black race and clinical T stage were associated with delayed surgery. Rates of pathologic upstaging, downstaging, complete response, and positive margins were not significantly different between the groups. Patients with delayed surgery had increased major morbidity as measured by a composite of length of hospital stay, readmission, and 30-day mortality [42.3% (22/52) vs 22.3% (355/1589), p = 0.001]. However, delayed surgery was not associated with a significant difference in survival in both univariate [5-year survival 32.8% (95% CI 21.1-50.7) vs 47.3% (44.7-50.1), p = 0.19] and multivariable analysis [hazard ratio (HR) 1.23 (0.85-1.78), p = 0.26].

conclusionsDelaying surgery longer than 180 days after starting chemoradiation for esophageal squamous cell carcinoma is associated with worse perioperative outcomes but not long-term survival.

Indexed as

Carcinoma, Squamous CellEsophageal NeoplasmsEsophageal Squamous Cell CarcinomaChemoradiotherapyEsophagectomyHumansNeoplasm StagingProportional Hazards ModelsRetrospective StudiesTreatment Outcome

Identifiers

PMID36572807
OpenAlexW4312185606

What OpenQuestion holds

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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.