Evidence map›Paper›PMID 39387473›Full record

ArticleJournal of surgical oncology2024

Current National Treatment Trends for Gastric Adenocarcinoma in the United States.

Dominic J Vitello, Norah N Zaza, Kelly R Bates, Lauren M Janczewski, Gladys Rodriguez, David J Bentrem

Erratum issuedAbstract read
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. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Dominic J VitelloDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID http://orcid.org/0000-0002-4163-7759
Norah N ZazaDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Kelly R BatesDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Lauren M JanczewskiDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Gladys RodriguezDepartment of Hematology and Medical Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
David J BentremDepartment of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Funding

COllaborative Northwestern Surgical Oncology Research Training (CONSORT)T32CA247801 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI ACKERMANN, RONALD T., KHAN, SEEMA AHSAN · 2020 to 2024
$1.3M
Surgical Multispecialty Access to Research in Residency Training (SMART)R38CA245095 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI KHAN, SEEMA AHSAN · 2021 to 2024
$1.0M
NCI NIH HHS R38 CA245095NCI NIH HHS T32 CA247801This study was supported by National Institutes of Health (Grant 5R38CA245095); National Cancer Institute (Grant T32CA247801); Steven J. Stryker, MD Gastrointestinal Surgery Research and Education Endowment.
6 · The paper itself

Abstract

purposeThe treatment of gastric adenocarcinoma (GA) continues to evolve. While neoadjuvant chemotherapy (NAC) has demonstrated emerging benefit, the optimal treatment regimen, and sequence remain to be firmly established.

methodsPatients with nonmetastatic GA who underwent resection were identified within the 2020 National Cancer Database. Patients were compared between the mutually exclusive treatment groups of NAC, neoadjuvant chemoradiotherapy (NCRT), adjuvant chemotherapy, adjuvant chemoradiotherapy (CRT), and surgery only. The primary endpoint was receipt of NAC or NCRT. Patients were 1-to-1 propensity score matched for receiving any neoadjuvant therapy. Multivariable logistic regression was used to identify predictors of receipt of any neoadjuvant therapy and receipt of any adjuvant therapy.

resultsTwenty-five thousand and seventy-three patients were included in the analysis. Patients were treated with NAC (25.0%), NCRT (31.4%), adjuvant chemotherapy (6.5%), adjuvant CRT (12.6%), and surgery only (24.5%). Compared to 2006-2011, patients diagnosed between 2012 and 2017 experienced the greatest increases in NAC (18.6% vs. 29.0%; p < 0.001) and NCRT (25.0% vs. 35.5%; p < 0.001). Median OS was 44.9 months. OS was longest for patients who received any neoadjuvant therapy compared to those receiving adjuvant or surgery only (51.0 vs. 42.4 vs. 38.0 months, respectively; p < 0.001). Patients who were Black, in the lowest income quartile or treated at lower volume facilities were less likely to receive NAT (all p < 0.001).

conclusionsThere has been significant acceleration in the use of neoadjuvant therapy for GA. Currently, NCRT followed by surgery are the most common treatment sequences in the United States. Additional trials are needed to further define the optimal treatment sequence.

Indexed as

AdenocarcinomaNeoadjuvant TherapyStomach NeoplasmsAgedChemoradiotherapy, AdjuvantChemotherapy, AdjuvantFemaleFollow-Up StudiesGastrectomyHumansMaleMiddle AgedRetrospective StudiesSurvival RateUnited Statesadjuvant therapychemoradiotherapygastric adenocarcinomaneoadjuvant therapy

Identifiers

PMID39387473
PMCPMC11849711

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Registered trials

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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.