Evidence map›Paper›PMID 39485887›Full record

Trial reportBJS open2024

Effects of the superior mesenteric artery approach versus the no-touch approach during pancreatoduodenectomy on the mobilization of circulating tumour cells and clusters in pancreatic cancer (CETUPANC): randomized clinical trial.

Javier Padillo-Ruiz, Cristóbal Fresno, Gonzalo Suarez, Gerardo Blanco, Luis Muñoz-Bellvis, Iago Justo, Maria I García-Domingo, Fabio Ausania, Elena Muñoz-Forner, Alejandro Serrablo and 17 more

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03340844 (Role of Circulating Tumor Cells), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

NCT03340844 nacompletednot on this map

Role of Circulating Tumor Cells (CTC´s) Spread During Pancreaticoduodenectomy in Metastasis and Survival Rates in Patients With Pancreatic and Periampullary Tumors

TypeinterventionalSponsorFundación Pública Andaluza para la gestión de la Investigación en SevillaRan2017 to 2023Enrolled86ConditionsPancreatic Tumor, Periampullary Carcinoma Resectable, Circulating Tumor Cells, MetastasisArmsNo Touch (NT), Superior Mesenteric Artery First (SMA)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Javier Padillo-RuizDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.ORCID 0000-0002-1220-0822
Cristóbal FresnoHealth and Sciences Research Centre, Health and Sciences Faculty, Anahuac University, Huixquilucan, Mexico.
Gonzalo SuarezDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Gerardo BlancoDepartment of Surgery, Badajoz University Hospital, University of Extremadura, Badajoz, Spain.ORCID 0000-0003-4845-5306
Luis Muñoz-BellvisDepartment of Surgery, University Hospital of Salamanca, Salamanca Biosanitary Institute, University of Salamanca, Salamanca, Spain.
Iago JustoDepartment of Surgery, University Hospital October 12 in Madrid, Madrid, Spain.
Maria I García-DomingoDepartment of Surgery, Terrassa Mutual University Hospital, Terrassa, Spain.
Fabio AusaniaHospital-Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.ORCID 0000-0001-8891-2546
Elena Muñoz-FornerDepartment of Surgery, Valencia Clinical Hospital, University of Valencia, Biomedical Research Institute, INCLIVA, Valencia, Spain.
Alejandro SerrabloDepartment of Surgery, Miguel Servet University Hospital, Zaragoza, Spain.
Elena MartinDepartment of Surgery, Princess University Hospital, Madrid, Spain.
Luis DíezDepartment of Surgery, Clinical Hospital, Madrid, Spain.
Carmen CepedaDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Luis MarinDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Jose AlamoDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.ORCID 0000-0002-8503-7552
Carmen BernalDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Sheila PereiraDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Francisco CaleroDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Jose TinocoDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Sandra PaternaDepartment of Surgery, Miguel Servet University Hospital, Zaragoza, Spain.
Esteban CugatDepartment of Surgery, Terrassa Mutual University Hospital, Terrassa, Spain.
Constantino FondevilaHospital-Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
Elisa Diego-AlonsoDepartment of Surgery, University Hospital of Salamanca, Salamanca Biosanitary Institute, University of Salamanca, Salamanca, Spain.
Diego López-GuerraDepartment of Surgery, Badajoz University Hospital, University of Extremadura, Badajoz, Spain.
Miguel GomezDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Valeria DenninghoffDepartment of Surgery, Virgen del Rocío University Hospital, IBIS, University of Seville, Seville, Spain.
Luis SabaterDepartment of Surgery, Valencia Clinical Hospital, University of Valencia, Biomedical Research Institute, INCLIVA, Valencia, Spain.

Funding

Instituto de Salud Carlos III
6 · The paper itself

Abstract

backgroundPatients with pancreatic ductal adenocarcinoma present early postoperative systemic metastases, despite complete oncological resection. The aim of this study was to assess two pancreatoduodenectomy approaches with regard to intraoperative circulating tumour cells and cluster mobilization and their potential association with the development of distant metastasis.

methodsPatients with periampullary tumours who underwent open pancreatoduodenectomy were randomly allocated to either the no-touch approach or the superior mesenteric artery approach. A total of four intraoperative portal vein samples (at the beginning of the intervention, after portal vein disconnection from the tumour, after tumour resection, and before abdominal closure) were collected to measure circulating tumour cells and cluster numbers. Primary outcomes were the intraoperative number of circulating tumour cells and cluster mobilization. Further, their potential impact on 3-year distant metastasis disease-free survival and overall survival was assessed.

resultsA total of 101 patients with periampullary tumours were randomized (51 in the superior mesenteric artery group and 50 in the no-touch group) and 63 patients with pancreatic ductal adenocarcinoma (34 in the superior mesenteric artery group and 29 in the no-touch group) were analysed. Circulating tumour cells and cluster mobilization were similar in both the no-touch group and the superior mesenteric artery group at all time points. There were no significant differences between surgical groups with regard to the median metastasis disease-free survival (12.4 (interquartile range 6.1-not reached) months in the superior mesenteric artery group and 18.1 (interquartile range 12.1-not reached) months in the no-touch group; P = 0.730). Patients with intraoperative cluster mobilization from the beginning to the end of surgery developed significantly more distant metastases within the first year after surgery (P = 0.023). Two intraoperative factors (the superior mesenteric artery approach (P = 0.025) and vein resection (P < 0.001)) were predictive factors for cluster mobilization.

conclusionPatients undergoing pancreatoduodenectomy using either the no-touch approach or the superior mesenteric artery approach had similar circulating tumour cells and cluster mobilization and similar overall survival and metastasis disease-free survival. A high intraoperative cluster dissemination during pancreatoduodenectomy was a predictive factor for early metastases in patients with pancreatic ductal adenocarcinoma. REGISTRATION NUMBER: NCT03340844 (http://www.clinicaltrials.gov)-CETUPANC trial.

Indexed as

Carcinoma, Pancreatic DuctalMesenteric Artery, SuperiorNeoplastic Cells, CirculatingPancreatic NeoplasmsPancreaticoduodenectomyAgedDisease-Free SurvivalFemaleHumansMaleMiddle AgedTreatment Outcome

Identifiers

PMID39485887
PMCPMC11529789

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Registered trials

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.