Evidence map›Paper›PMID 38127213›Full record

ArticleAnnals of surgical oncology2024

Multimodal Therapy Versus Primary Surgery for Gastric and Gastroesophageal Junction Diffuse Type Carcinoma, with a Focus on Signet Ring Cell Carcinoma: A Nationwide Study.

Emma C Gertsen, Arjen van der Veen, Hylke J F Brenkman, Lodewijk A A Brosens, Rachel S van der Post, Rob H A Verhoeven, Josianne C H B M Luijten, Pauline A J Vissers, Erik Vegt, Richard van Hillegersberg and 2 more

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 17% 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

5 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Perioperative chemotherapy strategies in diffuse gastric cancer.World journal of gastrointestinal surgery · 2025
    Article
  5. 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

12 authors at 4 institutions in 1 country.

Emma C Gertsen *Division Cancer Center, Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. E.C.Gertsen@umcutrecht.nl.ORCID http://orcid.org/0000-0001-9230-1158
Arjen van der Veen *Division Cancer Center, Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Hylke J F BrenkmanDivision Cancer Center, Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Lodewijk A A BrosensDepartment of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Rachel S van der PostDepartment of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
Rob H A VerhoevenDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.
Josianne C H B M LuijtenDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.
Pauline A J VissersDepartment of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.
Erik VegtDepartment of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Richard van HillegersbergDivision Cancer Center, Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Peter D SiersemaDepartment of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands.
Jelle P RuurdaDivision Cancer Center, Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Utrecht University · NLNetherlands Comprehensive Cancer Organisation · NLRadboud University Nijmegen · NLErasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiffuse type adenocarcinoma and, more specifically, signet ring cell carcinoma (SRCC) of the stomach and gastroesophageal junction (GEJ) have a poor prognosis and the value of neoadjuvant chemo(radio)therapy (nCRT) is unclear.

methodsAll patients who underwent surgery for diffuse type gastric and GEJ carcinoma between 2004 and 2015 were retrospectively included from the Netherlands Cancer Registry. The primary outcome was overall survival after surgery. Kaplan-Meier curves were plotted. Furthermore, multivariable Poisson and Cox regressions were performed, correcting for confounders. To comply with the Cox regression proportional hazard assumption, gastric cancer survival was split into two groups, i.e. <90 days and >90 days, postoperatively by adding an interaction variable.

resultsAnalyses included 2046 patients with diffuse type cancer: 1728 gastric cancers (50% SRCC) and 318 GEJ cancers (39% SRCC). In the gastric cancer group, 49% received neoadjuvant chemotherapy (nCT) and 51% received primary surgery (PS). All-cause mortality within 90 days postoperatively was lower after nCT (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.20-0.44; p < 0.001). Also after 90 days, mortality was lower in the nCT group (HR for the interaction variable 2.84, 95% CI 1.87-4.30, p < 0.001; total HR 0.29*2.84 = 0.84). In the GEJ group, 38% received nCT, 22% received nCRT, and 39% received PS. All-cause mortality was lower after nCT (HR 0.63, 95% CI 0.43-0.93; p = 0.020) compared with PS. The nCRT group was removed from the Cox regression analysis since the Kaplan-Meier curves of nCRT and PS intersected. The results for gastric and GEJ carcinomas were similar between the SRCC and non-SRCC subgroups.

conclusionFor gastric and GEJ diffuse type cancer, including SRCC, nCT was associated with increased survival.

Indexed as

AdenocarcinomaCarcinoma, Signet Ring CellStomach NeoplasmsEsophagogastric JunctionHumansNeoplasm StagingRetrospective StudiesDiffuse typeGastric cancerPerioperative treatmentSignet ring cell carcinomaSurvival

Identifiers

PMID38127213
OpenAlexW4390061111

What OpenQuestion holds

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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.