Evidence map›Paper›PMID 36622527›Full record

ArticleAnnals of surgical oncology2023

Predictors, Patterns, and Impact of Adequate Lymphadenectomy in Intrahepatic Cholangiocarcinoma.

Zorays Moazzam, Laura Alaimo, Yutaka Endo, Henrique A Lima, Timothy M Pawlik

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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 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
10.2field-weighted citation impact, top 1% 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

15 citing papers in PubMed, 32 citations in OpenAlex.

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  15. Is Lymphadenectomy Reasonable for Elderly Intrahepatic Cholangiocarcinoma Patients?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Zorays MoazzamDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Columbus, OH, USA.
Laura AlaimoDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Columbus, OH, USA.
Yutaka EndoDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Columbus, OH, USA.
Henrique A LimaDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Columbus, OH, USA.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Columbus, OH, USA. tim.pawlik@osumc.edu.ORCID http://orcid.org/0000-0002-7994-9870
The Ohio State University Wexner Medical Center · USThe Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite lymph node metastases (LNMs) being associated with worse survival, adequate lymph node evaluation (LNE) has not been universally adopted for intrahepatic cholangiocarcinoma (ICC). We sought to evaluate trends in LNE, predictors of LNE and LNM, as well as the role of adequate lymphadenectomy in stratifying patients relative to survival.

methodsPatients who underwent curative-intent liver resection for ICC (2010-2019) were identified from the National Cancer Database and stratified according to LNE: 0, 1-5 (inadequate lymphadenectomy) and ≥6 (adequate lymphadenectomy). Multivariate logistic regression was utilized to assess predictors of LNE and LNM. Overall survival and receipt of adequate lymphadenectomy were assessed relative to LNM and log-odds of lymph nodes (LODDS).

resultsAmong 6507 patients, adequate lymphadenectomy was performed in only 1118 (17.2%) patients, although compliance with adequate lymphadenectomy increased over time (2010-2012: 14.2% vs. 2016-2019: 18.9%; p < 0.001). After controlling for relevant factors, region (reference: Northeast; Midwest: odds ratio [OR] 1.90, 95% confidence interval [CI] 1.48-2.44; South: OR 1.64, 95% CI 1.28-2.10; West: OR 1.83, 95% CI 1.37-2.44) and preoperative nodal status (reference: cN0; cNx: OR 2.18, 95% CI 1.68-2.95; cN1: OR 3.88, 95% CI 3.02-4.98) strongly predicted adequate lymphadenectomy. Furthermore, adequate lymphadenectomy resulted in higher odds of detecting ≥1 LNMs (OR 2.63, 95% CI 2.25-3.08), regardless of preoperative nodal status. Adequate lymphadenectomy demonstrated an improved ability to stratify patients relative to 5-year survival based on LNM (N0: 51.3% vs. N1: 30.6% vs. N2: 13.7%; p < 0.001) and LODDS (LODDS1: 50.7% vs. LODDS2: 27.4% vs. LODDS3: 15.7%; p < 0.001).

conclusionsCompliance with adequate lymphadenectomy at the time of surgery for ICC remains suboptimal with marked regional variations. Adequate lymphadenectomy was associated with higher odds of detecting LNM and improved survival stratification relative to both LNM and LODDS. Greater emphasis on nodal evaluation is required to ensure optimal management of ICC.

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaBile Ducts, IntrahepaticHumansLymphatic MetastasisLymph Node ExcisionLymph NodesNeoplasm StagingPrognosisRetrospective Studies

Identifiers

PMID36622527
OpenAlexW4313877896

What OpenQuestion holds

Textmetadata
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.