Evidence map›Paper›PMID 40695449›Full record

ArticleInternational wound journal2025

Three-Year Recurrence in People With Diabetic Foot Ulcers and Chronic Limb Threatening Ischemia Is Comparable to Cancer.

Natalie S Armstrong, Alexandria A Armstrong, Joseph L Mills, Michael S Conte, Tze-Woei Tan, Richard S Swanson, David G Armstrong

Abstract readComparative Study
In one paragraph

Article in International wound journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing 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

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

  1. Pooled it
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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

7 authors.

Natalie S ArmstrongJohns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Alexandria A ArmstrongDepartment of Orthopaedics, Division of Podiatric Surgery, University of Texas Health Science Center, San Antonio, USA.
Joseph L MillsThe Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Michael S ConteDepartment of Surgery, University of California san Francisco, San Francisco, California, USA.
Tze-Woei TanSouthwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
Richard S SwansonDivision of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
David G ArmstrongSouthwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aimed to compare the 3-year recurrence rates of diabetic foot ulcers (DFU) and the rate of endovascular reintervention for chronic limb-threatening ischaemia (CLTI) to recurrence rates of advanced-stage cancers. We systematically collected original data reporting 3-year DFU recurrence from studies published through 2024 and calculated a pooled mean. These findings were compared to recurrence rates for advanced breast, prostate, colorectal, and lung cancers using contemporary sources from the National Cancer Institute and American Cancer Society. CLTI reintervention data were drawn from the BEST-CLI trial. The pooled 3-year DFU recurrence rate was 58%, while the CLTI reintervention rate was 50%-comparable to cancer recurrence rates: breast (25%-40%), prostate (30%-40%), colorectal (30%-50%), and lung (60%-80%). Despite these comparable risks, DFU and CLTI remain underrecognized in terms of their recurrent burden on individuals, families, and health systems. The data presented here underscore the need to reframe healed DFU and post-intervention CLTI not as an endpoint but as a remission-a state requiring structured surveillance and proactive management, much like in oncology. Developing interdisciplinary survivorship care plans for individuals with DFU and CLTI, modelled on those used in cancer care, may improve communication, enhance secondary prevention, and foster more ulcer-free, hospital-free, and activity-rich days.

Indexed as

Chronic Limb-Threatening IschemiaDiabetic FootIschemiaNeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedRecurrenceamputationdiabetesdiabetic footischemiaremissionwound healing

Identifiers

PMID40695449
PMCPMC12283117

What OpenQuestion holds

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LicenceCC BY
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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.