Evidence map›Paper›PMID 38153641›Full record

ArticleAnnals of surgical oncology2024

Sufficient Regional Lymph Node Examination for Staging Adenocarcinoma of the Appendix.

Felipe Lopez-Ramirez, Armando Sardi, Mary Caitlin King, Andrei Nikiforchin, Luis Felipe Falla-Zuniga, Philipp Barakat, Carol Nieroda, Vadim Gushchin

Abstract read
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In one paragraph

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 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.6field-weighted citation impact, top 16% 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, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Felipe Lopez-RamirezDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-3376-3827
Armando SardiDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA. asardi@mdmercy.com.ORCID http://orcid.org/0000-0003-4132-9489
Mary Caitlin KingDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-1560-9172
Andrei NikiforchinDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-4772-5477
Luis Felipe Falla-ZunigaDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0001-5065-1416
Philipp BarakatDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-5877-0521
Carol NierodaDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-6337-5278
Vadim GushchinDepartment of Surgical Oncology, Mercy Medical Center, The Institute for Cancer Care, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-6151-5660
Mercy Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe presence of lymph node (LN) metastasis is a known negative prognostic factor in appendix cancer (AC) patients. However, currently the minimum number of LNs required to adequately determine LN negativity is extrapolated from colorectal studies and data specific to AC is lacking. We aimed to define the lowest number of LNs required to adequately stage AC and assess its impact on oncologic outcomes.

methodsPatients with stage II-III AC from the National Cancer Database (NCDB 2004-2019) undergoing surgical resection with complete information about LN examination were included. Multivariable logistic regression assessed the odds of LN positive (LNP) disease for different numbers of LNs examined. Multivariable Cox regressions were performed by LN status subgroups, adjusted by prognostic factors, including grade, histologic subtype, surgical approach, and documented adjuvant systemic chemotherapy.

resultsOverall, 3,602 patients were included, from which 1,026 (28.5%) were LNP. Harvesting ten LNs was the minimum number required without decreased odds of LNP compared with the reference category (≥ 20 LNs). Total LNs examined were < 10 in 466 (12.9%) patients. Median follow-up from diagnosis was 75.4 months. Failing to evaluate at least ten LNs was an independent negative prognostic factor for overall survival (adjusted hazard ratio 1.39, p < 0.01).

conclusionsIn appendix adenocarcinoma, examining a minimum of ten LNs was necessary to minimize the risk of missing LNP disease and was associated with improved overall survival rates. To mitigate the risk of misclassification, an adequate number of regional LNs must be assessed to determine LN status.

Indexed as

AdenocarcinomaAppendiceal NeoplasmsAppendixHumansLymphatic MetastasisLymph Node ExcisionLymph NodesNeoplasm StagingPrognosisRetrospective StudiesAppendix cancerLymph node metastasisMisclassificationRegional lymph nodesStaging

Identifiers

PMID38153641
OpenAlexW4390346633

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.