Evidence map›Paper›PMID 39295157›Full record

ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2024

Splenic flexure adenocarcinoma: A national cohort analysis of extent of surgical resection and outcomes.

Julia F Kohn, Sonja Boatman, Qi Wang, Schelomo Marmor, Imran Hassan, Robert D Madoff, Wolfgang B Gaertner, Paolo Goffredo

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Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

8 authors.

Julia F KohnDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0002-2266-5113
Sonja BoatmanDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Qi WangClinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA.
Schelomo MarmorCenter for Clinical Quality and Outcomes Discovery and Evaluation (C-QODE), University of Minnesota, Minneapolis, Minnesota, USA.
Imran HassanDepartment of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Robert D MadoffDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Wolfgang B GaertnerDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Paolo GoffredoDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

Funding

Women's CancerP30CA077598 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI Jeffrey S. Miller · 1998 to 2026
$100.4M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
NCATS NIH HHS UL1 TR002494NCI NIH HHS P30 CA077598
6 · The paper itself

Abstract

aimThe optimal extent of resection for splenic flexure adenocarcinoma remains debated. These tumours straddle the left- and right-sided vasculature with lymphatic drainage in a watershed area; current guidelines recommend either segmental or extended colectomy. We analysed surgical management of splenic flexure tumours and compared outcomes between approaches.

methodThe Surveillance, Epidemiology and End Results database was searched for adults with Stage I-III splenic flexure adenocarcinoma, 2004-2019.

resultsOf 5238 patients, 55% underwent extended colectomy. Compared to segmental colectomy, these patients were more likely to have advanced stage. On multivariable analysis, age ≤ 65 years remained independently associated with extended colectomy. Although fewer nodes were examined in segmental colectomy (median 14 vs. 16, p < 0.001), the number of positive nodes (both, median 0 [interquartile ratio 0-2], p = 0.20) and the lymph node ratio were similar between cohorts. Surgical approach was not significantly associated with increased positive nodal yield in adjusted analyses. Five-year overall and disease-specific survival were 73% and 84% for segmental and 72% and 83% for extended colectomy (p > 0.4); these remained comparable after adjustment.

conclusionsNationally, we observed similar rates of segmental and extended colectomy for splenic flexure adenocarcinoma. Extended colectomy was not more common in Stage III disease, indicating lack of stage migration, and was not associated with better oncological outcomes. These observations support current practice involving either approach, which should be tailored to patient-related factors and preferences, while considering technical aspects and quality of life.

Indexed as

AdenocarcinomaColectomyColonic NeoplasmsColon, TransverseNeoplasm StagingSEER ProgramAgedCohort StudiesFemaleHumansMaleMiddle AgedTreatment Outcomecolon adenocarcinomaextended colectomyNCDBoutcomessegmental colectomysplenic flexure

Identifiers

PMID39295157
PMCPMC11576260

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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.