Evidence map›Paper›PMID 38155339›Full record

SynthesisAnnals of surgical oncology2024

Is Precision Surgery Applicable to Colorectal Liver Metastases? A Systematic Review and Meta-analysis of Studies that Investigate the Association of Surgical Technique with Outcomes in the Context of Distinct Tumor Biology.

Emmanouil Pikoulis, Dimitrios Papaconstantinou, Anastasia Pikouli, Nikolaos Pararas, Stefan Buettner, Jane Wang, Georgios Stasinos, Michail Belias, Dionysios Dellaportas, Ioannis Pozios and 5 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis 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 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

8 citing papers in PubMed, 8 citations in OpenAlex.

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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

15 authors at 7 institutions in 4 countries.

Emmanouil PikoulisThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Dimitrios PapaconstantinouThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Anastasia PikouliThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Nikolaos PararasThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Stefan BuettnerDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Jane WangDepartment of Surgery, University of California San Francisco, San Francisco, CA, USA.
Georgios StasinosTechnical Chamber of Greece, Athens, Greece.
Michail BeliasHealth Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
Dionysios DellaportasThird Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Ioannis PoziosDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Efstathios AntoniouSecond Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Katharina BeyerDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Martin E KreisDepartment of General and Visceral Surgery, Charité Campus Benjamin Franklin, Berlin, Germany.
Timothy M PawlikDepartment of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Georgios Antonios MargonisDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. margonig@mskcc.org.ORCID http://orcid.org/0000-0003-4894-5743
National and Kapodistrian University of Athens · GRCharité - Universitätsmedizin Berlin · DEErasmus MC Cancer Institute · NLMemorial Sloan Kettering Cancer Center · USRadboud University Nijmegen · NLThe Ohio State University Wexner Medical Center · USUniversity of California, San Francisco · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748NCI NIH HHS P30-CA008748
6 · The paper itself

Abstract

backgroundAlthough some data suggest that patients with mutRAS colorectal liver metastases (CRLM) may benefit from anatomic hepatectomy, this topic remains controversial. We performed a systematic review and meta-analysis to determine whether RAS mutation status was associated with prognosis relative to surgical technique [anatomic resection (AR) vs. nonanatomic resection (NAR)] among patients with CRLM. PATIENTS AND

methodsA systematic review and meta-analysis of studies were performed to investigate the association of AR versus NAR with overall and liver-specific disease-free survival (DFS and liver-specific DFS, respectively) in the context of RAS mutation status.

resultsOverall, 2018 patients (831 mutRAS vs. 1187 wtRAS) were included from five eligible studies. AR was associated with a 40% improvement in liver-specific DFS [hazard ratio (HR) = 0.6, 95% confidence interval (CI) 0.44-0.81, p = 0.01] and a 28% improvement in overall DFS (HR = 0.72, 95% CI 0.54-0.95, p = 0.02) among patients with mutRAS tumors; in contrast, AR was not associated with any improvement in liver-specific DFS or overall DFS among wtRAS patients. These differences may have been mediated by the 40% decreased incidence in R1 resection among patients with mutRAS tumors who underwent AR versus NAR [relative risk (RR): 0.6, 95% CI 0.40-0.91, p = 0.02]. In contrast, the probability of an R1 resection was not decreased among wtRAS patients who underwent AR versus NAR (RR: 0.93, 95% CI 0.69-1.25, p = 0.62).

conclusionsThe data suggest that precision surgery may be relevant to CRLM. Specifically, rather than a parenchymal sparing dogma for all patients, AR may have a role in individuals with mutRAS tumors.

Indexed as

Colorectal NeoplasmsHepatectomyLiver NeoplasmsHumansMutationPrecision MedicinePrognosisSurvival RateAnatomicHepatectomyPrecision surgeryRAS mutationRecurrence

Identifiers

PMID38155339
PMCPMC11293459
OpenAlexW4390311624

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.