Evidence map›Paper›PMID 37935921›Full record

ArticleSurgical endoscopy2024

Identifying the optimal treatment strategy in patients with resectable non-cardia gastric cancer.

Pranay S Ajay, Raja Kumaran Rajamanickam, Kevin Rhee, Rachel NeMoyer, Subir Goyal, Jeffery M Switchenko, Yong Lin, Salma K Jabbour, Darren R Carpizo, Timothy J Kennedy and 1 more

Open access · greenAbstract read
In one paragraph

Article in Surgical endoscopy, 2024. 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
0.3field-weighted citation impact, top 34% 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, 1 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

11 authors at 5 institutions in 1 country.

Pranay S AjayDivision of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Raja Kumaran RajamanickamDivision of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Kevin RheeDivision of General Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Rachel NeMoyerDivision of Thoracic and Cardiothoracic Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Subir GoyalDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Jeffery M SwitchenkoDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Yong LinDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, New Brunswick, NJ, USA.
Salma K JabbourDivision of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA.
Darren R CarpizoDivision of Surgical Oncology, Wilmot Cancer Institute, University of Rochester, Rochester, NY, USA.
Timothy J KennedyDivision of Surgical Oncology, Department of Surgery, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA.
Mihir M ShahDivision of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA. mihir.m.shah@emory.edu.ORCID 0000-0002-4665-5534
Rutgers, The State University of New Jersey · USEmory University · USCleveland Clinic · USEmory Healthcare · USUniversity of Rochester · US

Funding

Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
Winship Cancer Institute Cancer Center Support GrantP30CA138292 · NCI · EMORY UNIVERSITY · PI Suresh S Ramalingam · 2009 to 2026
$47.5M
Emory Clinical Oncology Career Development Award K12 ProgramK12CA237806 · NCI · EMORY UNIVERSITY · PI DHODAPKAR, KAVITA MADHAV, RAMALINGAM, SURESH S · 2019 to 2023
$2.2M
NCATS NIH HHS UL1 TR002378NCI NIH HHS K12 CA237806NCI NIH HHS P30 CA138292
6 · The paper itself

Abstract

backgroundMultimodal treatment strategy including perioperative chemotherapy (PEC), postoperative chemoradiation therapy (POCR), and postoperative chemotherapy (POC) has been accepted as the standard of care in gastric cancer (GC). The ideal sequence and type of therapy remain undetermined.

methodThe National Cancer Database was examined from 2006 to 2016 to identify patients with resectable non-cardia gastric cancer. Patient outcomes were compared based on the receipt of PEC, POCR, and POC. This comparison was repeated in a sub-group of patients who received optimal treatment. Optimal treatment was defined as initial chemotherapy within 45 days of diagnosis, resection within 45 days of diagnosis, negative margins, adjuvant chemotherapy within 90 days of resection and standard radiation dose (45 Gy). Kaplan-Meier test, log-rank test, and multivariable analysis (MVA) were performed.

resultsWe identified 9589 patients. Median survival was greater in the PEC group followed by POCR and POC (60.6, 42.3, and 31.2 months, respectively). On MVA, factors associated with worse overall survival included age above median (≥ 63 years), Charlson-Deyo score of ≥ 1, non-academic/research program, poorly differentiated/undifferentiated grade, positive margins, and positive lymph nodes. Both PEC and POCR were associated with improved survival when compared to POC (HR 0.78 and 0.79; p < 0.001). When compared with PEC, no significant difference was noted with POCR (HR 1.01; p = 0.987). These results were maintained in optimally treated cohort (n = 3418).

conclusionIn patients with resectable non-cardia gastric cancer, both perioperative chemotherapy and postoperative chemoradiation therapy were associated with improved survival when compared to postoperative chemotherapy. No difference was noted between perioperative chemotherapy and postoperative chemoradiation therapy. These results were maintained in the optimally treated cohort.

Indexed as

Stomach NeoplasmsChemoradiotherapyChemotherapy, AdjuvantCombined Modality TherapyGastrectomyHumansMiddle AgedNeoplasm StagingGastric cancerNon-cardia gastric cancerTreatment strategies in gastric cancer

Identifiers

PMID37935921
PMCPMC10843560
OpenAlexW4388450716

What OpenQuestion holds

Textmetadata
LicenceTDM
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.