Evidence map›Paper›PMID 39068306›Full record

ArticleAnnals of surgical oncology2024

Distinct Indications for Adjuvant Therapy in Resected Invasive Mucinous Cystic Neoplasms of the Pancreas Compared with Pancreatic Ductal Adenocarcinoma.

Paul Wong, Tommaso Pollini, Mohamed A Adam, Adnan Alseidi, Carlos U Corvera, Kenzo Hirose, Kimberly S Kirkwood, Eric K Nakakura, Lucas Thornblade, Ajay V Maker

Abstract readComparative Study
PubMed Full text at PMC Publisher
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. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Paul WongDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Tommaso PolliniDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Mohamed A AdamDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Adnan AlseidiDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Carlos U CorveraDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Kenzo HiroseDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Kimberly S KirkwoodDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Eric K NakakuraDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Lucas ThornbladeDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA.
Ajay V MakerDivision of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, USA. ajay.maker@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical and adjuvant management of mucinous cystic neoplasms (MCNs) lacks formal guidelines and data is limited to institutional studies. Factors associated with receipt of adjuvant therapy and any associated impact on survival remain to be clarified. In the absence of other data, guidelines that recommend adjuvant chemotherapy for invasive pancreatic adenocarcinoma have been extrapolated to MCN. PATIENTS AND

methodsThe National Cancer Database (2004-2019) was utilized to identify all patients that underwent pancreatic resection for invasive MCNs. Patients that received neoadjuvant therapy or did not undergo lymphadenectomy were excluded. Patient, tumor, and treatment factors associated with survival were assessed.

resultsFor 161 patients with invasive MCN, median overall survival (OS) was 133 months and 45% of patients received adjuvant therapy. Multivariable analysis demonstrated that poorly differentiated tumors [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.47-11.98; p = 0.008] and positive lymph node status (OR 2.67, 95% CI 1.02-6.98; p = 0.042) were independent predictors of receiving adjuvant therapy. Lymph node positivity [hazard ratio (HR) 2.90, 95% CI 1.47-5.73; p = 0.002], positive margins (HR 5.28, 95% CI 2.28-12.27; p < 0.001), and stage III disease (HR 12.46, 95% CI 1.40-111.05; p = 0.024) were associated with worse OS. Receipt of adjuvant systemic therapy was independently associated with decreased risk of mortality in node positive patients (HR 0.23, 95% CI 0.10-0.69; p = 0.002). Survival was not associated with adjuvant therapy in patients with negative lymph nodes or margin negative status.

conclusionIn contrast to pancreatic ductal adenocarcinoma (PDAC), where adjuvant therapy improves OS for every tumor stage, surgery alone for invasive MCN is not associated with improved OS compared with surgery plus adjuvant therapy in node-negative patients. Surgery alone is likely sufficient for a subset of invasive MCN.

Indexed as

Carcinoma, Pancreatic DuctalPancreatectomyPancreatic NeoplasmsAgedChemotherapy, AdjuvantCystadenocarcinoma, MucinousFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm InvasivenessPrognosisRetrospective StudiesSurvival Rate

Identifiers

PMID39068306
PMCPMC11467002

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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.