Evidence map›Paper›PMID 41816583›Full record

ArticleJournal of gastrointestinal oncology2026

The association between adherence to elective nodal volume guidelines and reduced distant metastasis in esophageal and gastroesophageal junction cancer: a retrospective analysis of elective nodal irradiation.

Jared Lyons, Garrett Harada, John Yeakel, Farshid Dayyani, Brian Smith, Shaun Daly, Ninh Nguyen, Harada Keshava, Suzanne Dufault, Caressa Hui and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Jared LyonsIrvine School of Medicine, University of California, Irvine, CA, USA.
Garrett HaradaDepartment of Radiation Oncology, University of California, Irvine, Orange, CA, USA.
John YeakelDepartment of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Farshid DayyaniDivision of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA.
Brian SmithDepartment of Surgery, University of California, Irvine, Orange, CA, USA.
Shaun DalyDepartment of Surgery, University of California, Irvine, Orange, CA, USA.
Ninh NguyenDepartment of Surgery, University of California, Irvine, Orange, CA, USA.
Harada KeshavaDivision of Cardiothoracic Surgery, Department of Surgery, University of California, Irvine, Orange, CA, USA.
Suzanne DufaultDivision of Biostatistics, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
Caressa HuiDepartment of Radiation Oncology, University of California, Irvine, Orange, CA, USA.
Alexandra HotcaDepartment of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA.
Steven SeyedinDepartment of Radiation Oncology, University of California, Irvine, Orange, CA, USA.ORCID https://orcid.org/0000-0002-6841-968X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: In 2015, expert guidelines on esophageal/gastroesophageal junction (GEJ) cancer contouring for intensity-modulated radiation therapy (IMRT) were published in Methods: Patients treated for non-metastatic esophageal or GEJ cancer with CRT pre-operatively or definitively from 2012 to 2021 were retrospectively identified from a single institution database. Radiation plans of eligible patients were then analyzed by tumor location. Plans were deemed guideline-compliant if radiation dose coverage, greater than 41.4 Gy, encompassed nodal basins recommended by the 2015 guidelines. The primary endpoint of this study was the overall rate of distant metastatic disease. Summary and descriptive statistics were used to characterize key cohort features. Results: With a median follow-up of 22.3 months, 38 patients, with a median age at diagnosis of 66 years, were included in the study. Most patients were male (94.7%) with cT3 (52.6%), cN0 (44.7%), moderately differentiated (44.7%) and poorly differentiated (44.7%) adenocarcinoma (73.7%) located at the GEJ (57.9%). The median radiation dose used was 50.4 Gy, with most patients receiving concurrent carboplatin and paclitaxel (86.8%). Four patients received induction chemotherapy and 20 (52.6%) underwent esophagectomy. When examining guideline compliance, 17 (44.7%) radiation plans demonstrated adequate elective nodal irradiation (ENI). The most common improperly covered nodal basin was para-aortic (66.7%), followed by gastrohepatic (23.8%). One patient with sufficient ENI coverage (1/17) developed distant failure compared to 38.1% (8/21) with insufficient coverage (P=0.02). There were inappreciable differences in locoregional or local failure rates between those with and without complete ENI. Conclusions: These results suggest that proper coverage of nodal basins could improve distant metastasis. ENI analysis of previous prospective CRT studies for esophageal cancer could validate these findings.

Indexed as

chemoradiotherapy (CRT)Gastroesophageal (GE)metastasesnodes

Identifiers

PMID41816583
PMCPMC12972001

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