Evidence map›Paper›PMID 36912973›Full record

SynthesisInternational journal of colorectal disease2023

Impact of the 12-gene recurrence score in influencing adjuvant chemotherapy prescription in mismatch repair proficient stage II/III colonic carcinoma-a systematic review and meta-analysis.

Matthew G Davey, Maeve O'Neill, Mark Regan, Babak Meshkat, Emmeline Nugent, Myles Joyce, Aisling M Hogan

Open access · hybridFull text readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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.

Matthew G DaveyDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland. m.davey7@nuigalway.ie.
Maeve O'NeillDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
Mark ReganDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
Babak MeshkatDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
Emmeline NugentDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
Myles JoyceDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
Aisling M HoganDepartment of Surgery, Galway University Hospitals, Galway, H91 YRY71, Ireland.
University Hospital Galway · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe 12-gene recurrence score (RS) is a clinically validated assay which predicts recurrence risk in patients with stage II/III colon cancer. Decisions regarding adjuvant chemotherapy may be guided using this assay or based on the judgement of tumour board.

aimsTo assess the concordance between the RS and MDT decisions regarding adjuvant chemotherapy in colon cancer.

methodsA systematic review was performed in accordance with PRISMA guidelines. Meta-analyses were performed using the Mantel-Haenszel method using the Review Manager version 5.4 software.

resultsFour studies including 855 patients with a mean age of 68 years (range: 25-90 years) met inclusion criteria. Overall, 79.2% had stage II disease (677/855) and 20.8% had stage III disease (178/855). For the entire cohort, concordant results between the 12-gene assay and MDT were more likely than discordant (odds ratio (OR): 0.38, 95% confidence interval (CI): 0.25-0.56, P < 0.001). Patients were more likely to have chemotherapy omitted than escalated when using the RS (OR: 9.76, 95% CI: 6.72-14.18, P < 0.001). For those with stage II disease, concordant results between the 12-gene assay and MDT were more likely than discordant (OR: 0.30, 95% CI: 0.17-0.53, P < 0.001). In stage II disease, patients were more likely to have chemotherapy omitted than escalated when using the RS (OR: 7.39, 95% CI: 4.85-11.26, P < 0.001).

conclusionsThe use of the 12-gene signature refutes the decision of tumour board in 25% of cases, with 75% of discordant decisions resulting in omission of adjuvant chemotherapy. Therefore, it is possible that a proportion of such patients are being overtreated when relying on tumour board decisions alone.

Indexed as

CarcinomaColonic NeoplasmsAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantDNA Mismatch RepairHumansNeoplasm StagingAdjuvant therapiesCancer genomicsColon cancerPersonalised medicine

Identifiers

PMID36912973
PMCPMC10011316
OpenAlexW4324017934

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read45
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.