Evidence map›Paper›PMID 36882628›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023

Preoperative Esophageal Stenting and 5-Year Survival in Patients Undergoing Esophagectomy for Esophageal Cancer: a Population-Based Nationwide Study from Finland.

Olli Helminen, Eero Sihvo, Mika Helmiö, Heikki Huhta, Raija Kallio, Vesa Koivukangas, Arto Kokkola, Simo Laine, Elina Lietzen, Sanna Meriläinen and 10 more

Open access · hybridAbstract read
In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 33% 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

3 citing papers in PubMed, 2 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

20 authors at 7 institutions in 2 countries.

Olli HelminenSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland. olli.helminen@oulu.fi.ORCID 0000-0001-9544-6475
Eero SihvoDepartment of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
Mika HelmiöDivision of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
Heikki HuhtaDepartment of Surgery, Central Finland Central Hospital, Jyväskylä, Finland.
Raija KallioDepartment of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland.
Vesa KoivukangasSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
Arto KokkolaDepartment of Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Simo LaineDivision of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
Elina LietzenDivision of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
Sanna MeriläinenSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
Vesa-Matti PohjanenCancer and Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
Tuomo RantanenDepartment of Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
Ari RistimäkiDepartment of Pathology and HUSLAB, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Jari V RäsänenDepartment of General Thoracic and Oesophageal Surgery, Heart and Lung Centre, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Juha SaarnioSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
Vesa ToikkanenDepartment of Cardiothoracic Surgery, Heart Center, Tampere University Hospital, University of Tampere, Tampere, Finland.
Tuula TyrväinenDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
Antti ValtolaDepartment of Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
Joonas H KauppilaSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
FINEGO group
Oulu University Hospital · FITurku University Hospital · FIUniversity of Helsinki · FICentral Finland Health Care District · FITampere University Hospital · FIUniversity of Eastern Finland · FIKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreoperative esophageal stenting is proposed to have a negative effect on outcomes. The aim was to compare a 5-year survival in patients undergoing esophagectomy for esophageal cancer with and without preoperative esophageal stent in a population-based nationwide cohort from Finland. The secondary outcome was 90-day mortality.

methodsThis study included curatively intended esophagectomies for esophageal cancer in Finland between 1999 and 2016, with follow-up until December 31, 2019. Cox proportional hazards models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of overall 5-year and 90-day mortality. Model 1 was adjusted for age, sex, year of the surgery, comorbidities, histology, pathological stage, and neoadjuvant therapy. Model 2 included also albumin level and BMI.

resultOf 1064 patients, a total of 134 patients underwent preoperative stenting and 930 did not. In both adjusted models 1 and 2, higher 5-year mortality was seen in patients with preoperative stent with HRs of 1.29 (95% CI 1.00-1.65) and 1.25 (95% CI 0.97-1.62), respectively, compared to no stenting. The adjusted HR of 90-day mortality was 2.49 (95% CI 1.27-4.87) in model 1 and 2.49 (95% CI 1.25-4.99) in model 2. When including only neoadjuvant-treated patients, those with preoperative stent had a 5-year survival of 39.2% compared to 46.4% without stent (adjusted HR 1.34, 95% CI 1.00-1.80), and a 90-day mortality rate of 8.5% and 2.5% (adjusted HR 3.99, 95% CI 1.51-10.50). DISCUSSION: This nationwide study reports worse 5-year and 90-day outcomes in patients with preoperative esophageal stent. Since residual confounding remains possible, observed difference could be only an association rather than the cause.

Indexed as

AdenocarcinomaEsophageal NeoplasmsEsophagectomyFinlandHumansStentsTreatment OutcomeBridge to surgeryEsophageal cancerEsophageal stentEsophagectomyNutritionSurvival

Identifiers

PMID36882628
PMCPMC10267252
OpenAlexW4323532872

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.