Evidence map›Paper›PMID 37405554›Full record

SynthesisInternational journal of colorectal disease2023

Upfront primary tumor resection versus upfront systemic therapy for metastatic colorectal cancer: a systematic review and meta-analysis.

Shih-Jung Lo, Shu-Huan Huang, I-Li Lai, Yih-Jong Chern, Yu-Jen Hsu, Chun-Kai Liao, Ching-Chung Cheng, Wen-Sy Tsai, Pao-Shiu Hsieh, Jeng-Fu You

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 32% 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

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Review
  2. 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

10 authors at 2 institutions in 1 country.

Shih-Jung LoDepartment of Surgery, Chang Gung Memorial Hospital, Linkou, No.5, Fu-Hsing Street, Guei-Shan, Tao-Yuan, Taiwan.
Shu-Huan HuangDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
I-Li LaiDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Yih-Jong ChernDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Yu-Jen HsuDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Chun-Kai LiaoDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Ching-Chung ChengDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Wen-Sy TsaiDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Pao-Shiu HsiehDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan.
Jeng-Fu YouDivision of Colon and Rectal Surgery, Department of Surgery, College of Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 33305, Taiwan. jenodyssey@gmail.com.ORCID http://orcid.org/0000-0001-5748-1659
Chang Gung University · TWChang Gung Memorial Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe standard initial treatment for metastatic colorectal cancer (mCRC) remains debated. This study investigated whether upfront primary tumor resection (PTR) or upfront systemic therapy (ST) provides better survival outcomes for patients with mCRC.

methodsThe PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched for studies published at any time from January 1, 2004, to December 31, 2022. Randomized controlled trials (RCTs) and prospective or retrospective cohort studies (RCSs) utilizing propensity score matching (PSM) or inverse probability treatment weighting (IPTW) were included. We evaluated overall survival (OS) and short-term (60-day) mortality in these studies.

resultsAfter reviewing 3,626 articles, we identified 10 studies including a total of 48,696 patients. OS differed significantly between the upfront PTR and upfront ST arms (hazard ratio [HR] 0.62; 95% CI: 0.57-0.68; p < 0.001). However, a subgroup analysis identified no significant difference in OS in RCTs (HR 0.97; 95% CI: 0.7-1.34; p = 0.83), whereas significant difference in OS occurred between the treatment arms in RCSs with PSM or IPTW (HR 0.59; 95% CI: 0.54-0.64; p < 0.001). Short-term mortality was analyzed in three RCTs, and 60-day mortality differed significantly between the treatment arms (risk ratio [RR] 3.52; 95% CI: 1.23-10.10; p = 0.02).

conclusionsIn RCTs, upfront PTR for mCRC did not improve OS and enhanced the risk of 60-day mortality. However, upfront PTR seemed to increase OS in RCSs with PSM or IPTW. Therefore, whether upfront PTR should be used for mCRC remains unclear. Further large RCTs are required.

Indexed as

Colonic NeoplasmsColorectal NeoplasmsHumansProportional Hazards ModelsInverse probabilityMeta-analysisMetastatic colorectal cancerPrimary tumor resectionPropensity scoreSystematic review

Identifiers

PMID37405554
OpenAlexW4383186688

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.