Evidence map›Paper›PMID 40587056›Full record

Observational studyGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2025

Efficacy of nodal dissection for locoregional gastric neuroendocrine carcinoma: a multicenter retrospective observational study.

Yukinori Yamagata, Mitsuhiro Furuta, Akifumi Notsu, Hirofumi Yasui, Rie Makuuchi, Takanobu Yamada, Michihiro Ishida, Kunihiro Tsuji, Shigeaki Baba, Noriaki Tokumoto and 12 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2025. 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. 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

22 authors.

Yukinori YamagataDepartment of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan. yuyamaga@ncc.go.jp.ORCID 0000-0003-2624-1251
Mitsuhiro FurutaDepartment of Gastroenterology, Kanagawa Cancer Center, Kanagawa, Japan.
Akifumi NotsuClinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan.
Hirofumi YasuiDivision of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Rie MakuuchiDepartment of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Takanobu YamadaDepartment of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan.
Michihiro IshidaDepartment of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Kunihiro TsujiDepartment of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
Shigeaki BabaDepartment of Surgery, School of Medicine, Iwate Medical University, Iwate, Japan.
Noriaki TokumotoDepartment of Gastroenterological Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan.
Shusuke HarutaDepartment of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Masaya WatanabeDepartment of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Takuya HamakawaDepartment of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Yasuyuki KawachiDepartment of Surgery, Nagaoka Chuo General Hospital, Niigata, Japan.
Norihiko SugisawaDepartment of Surgery, Miyagi Cancer Center, Miyagi, Japan.
Hiroshi YabusakiDepartment of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
Ryohei KawabataDepartment of Gastroenterological Surgery, Sakai City Medical Center, Osaka, Japan.
Yukinori KurokawaDepartment of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Narikazu BokuDepartment of Oncology and General Medicine, Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan.
Masanori TerashimaDivision of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Nozomu MachidaDepartment of Gastroenterology, Kanagawa Cancer Center, Kanagawa, Japan.
Takaki YoshikawaDepartment of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.

Funding

Japanese Gastric Cancer Association JGCA-040
6 · The paper itself

Abstract

backgroundGastric neuroendocrine carcinoma (NEC) is a rare and aggressive malignancy for which no standard treatment has been established for locoregional disease. This multicenter retrospective study aimed to evaluate the prognostic relevance and therapeutic efficacy of lymph node dissection in this setting.

methodsA total of 118 patients with gastric NEC or mixed adenoneuroendocrine carcinoma (MANEC) who underwent gastrectomy with lymph node dissection were analyzed. Survival outcomes, clinicopathological factors, and the therapeutic value index of each lymph node station were assessed. Lymph node involvement was classified using both the pathological N category and the extent of nodal involvement based on the dissection area (pND).

resultsThe 5-year overall survival and 3-year recurrence-free survival rates were 56.7% and 63.4%, respectively. Prognostic stratification using pND provided clearer separation than using the conventional pN category. Multivariate analysis identified older age, female sex, and pND2 (metastasis to D2 area nodes) as independent unfavorable prognostic factors. The therapeutic value index for lymph nodes in the D1 area was high (35.0, based on 5-year overall survival), whereas the index for D2 nodes was markedly lower (6.8). Notably, these indices remained consistent across histological subtypes, showing similar values between NEC and MANEC. Postoperative chemotherapy and surgical complications did not significantly affect survival outcomes.

conclusionsPerigastric (D1) lymph node dissection appears to provide meaningful survival benefit in locoregional gastric NEC, whereas the additional value of D2 dissection is limited. These findings support consideration of a more selective surgical approach, though further validation is needed.

Indexed as

AdenocarcinomaCarcinoma, NeuroendocrineGastrectomyLymph Node ExcisionStomach NeoplasmsAdultAgedAged, 80 and overFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleMiddle AgedPrognosisRetrospective StudiesGastrectomyGastric neuroendocrine carcinomaLymph node dissectionTherapeutic value index

Identifiers

PMID40587056

What OpenQuestion holds

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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.