Evidence map›Paper›PMID 39165230›Full record

ArticleJournal of surgical oncology2024

Lymph node metrics following neoadjuvant therapy to refine patient selection for adjuvant chemotherapy in resected pancreatic cancer: A multi-institutional analysis.

Haleh Amirian, Erin Dickey, Ifeanyichukwu Ogobuiro, Edmond W Box, Ankit Shah, Mary P Martos, Manan Patel, Gregory C Wilson, Rebecca A Snyder, Alexander A Parikh and 11 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

21 authors.

Haleh AmirianDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.ORCID http://orcid.org/0000-0002-6094-1342
Erin DickeyDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Ifeanyichukwu OgobuiroDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Edmond W BoxDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Ankit ShahDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Mary P MartosDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Manan PatelDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Gregory C WilsonDepartment of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Rebecca A SnyderDepartment of Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID http://orcid.org/0000-0002-2485-2481
Alexander A ParikhMays Cancer Center, UT Health San Antonio MD Anderson, San Antonio, Texas, USA.
Chet HammillDepartment of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.ORCID http://orcid.org/0000-0001-9749-0824
Hong J KimDepartment of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
Daniel AbbottDepartment of Surgery, University of Wisconsin, Madison, Wisconsin, USA.ORCID http://orcid.org/0000-0002-5539-0734
Shishir K MaithelDepartment of Surgery, Emory University, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0002-3591-8925
Syed Nabeel ZafarDepartment of Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Michael T LeCompteDepartment of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
David A KoobyDepartment of Surgery, Emory University, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0001-8694-0455
Syed A AhmadDepartment of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Nipun B MerchantDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Caitlin A HesterDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
Jashodeep DattaDepartment of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.

Funding

Disrupting MDSC-fibroblast interactions to overcome chemoimmunotherapy resistance in pancreatic cancerR37CA292843 · NCI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI Jashodeep Datta · 2024 to 2026
$1.1M
NCI NIH HHS R37 CA292843
6 · The paper itself

Abstract

backgroundIn patients with localized pancreatic ductal adenocarcinoma (PDAC) undergoing neoadjuvant therapy (NAT) and resection, selection of adjuvant chemotherapy (AC) is typically guided by high-risk features on histopathologic examination. We evaluated the interaction between post-NAT lymph node metrics and AC receipt on survival.

methodsPatients who received NAT followed by pancreatectomy (2010-2020) at seven centers were reviewed. Overall survival (OS) in patients receiving AC or not was stratified by lymph node positivity (LNP) or lymph node ratio (LNR) dichotomized at 0.1. Cox models evaluated the independent association between these nodal metrics, AC receipt, and OS.

resultsOf 464 patients undergoing NAT and resection, 264 (57%) received AC. Patients selected for AC were younger (median 63 vs. 67 years; p < 0.001), received shorter duration of NAT (2.8 vs. 3.2 months; p = 0.01), had fewer postoperative complications (Clavien-Dindo grade > 3: 1.2% vs. 11.7%; p < 0.001), and lower rates of pathologic complete response (4% vs. 11%; p = 0.01). The median number of nodes evaluated was similar between cohorts (n = 20 in both; p = 0.9). Post-NAT LNP rates were not different, and median LNR was 0.1, in AC and non-AC cohorts. Both LNP (hazard ratio [HR]: 2.1, p < 0.001) and LNR (0 < LNR ≤ 0.1: HR: 1.98, p = 0.002; LNR > 0.1: HR 2.46, p < 0.001) were independently associated with OS on Cox modeling, although receipt of AC was not associated with improved OS (median 30.6 vs. 29.4 months; p = 0.2). In patients with LNR > 0.1, receipt of AC was associated with significantly longer OS compared to non-AC (24 vs. 20 months, respectively; p = 0.04).

conclusionsLNR following NAT, not simply nodal positivity, may be useful to refine selection of AC in resected PDAC.

Indexed as

Carcinoma, Pancreatic DuctalLymph NodesNeoadjuvant TherapyPancreatectomyPancreatic NeoplasmsPatient SelectionAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective Studiesadjuvant chemotherapylymph node metricspancreatic ductal adenocarcinoma

Identifiers

PMID39165230
PMCPMC11654894

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.