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Record W2017498030 · doi:10.1001/archsurg.137.2.191

The Effect of Laparoscopy on Survival in Pancreatic Cancer

2002· article· en· W2017498030 on OpenAlexaff
David R. Urbach

Bibliographic record

VenueArchives of Surgery · 2002
Typearticle
Languageen
FieldMedicine
TopicPancreatic and Hepatic Oncology Research
Canadian institutionsUniversity of TorontoUniversity Health Network
FundersNational Cancer Institute
KeywordsMedicineLaparotomyPancreatic cancerLaparoscopyHazard ratioEndoscopic retrograde cholangiopancreatographySurgeryLaparoscopic surgeryConfidence intervalMalignancyProportional hazards modelCancerInternal medicinePancreatitis

Abstract

fetched live from OpenAlex

HYPOTHESIS: Exposure to laparoscopy influences survival in patients with unresected pancreatic cancer who have a diagnostic or staging surgical procedure. METHODS: We used the Surveillance, Epidemiology, and End Results Medicare-linked database to identify a cohort of persons 65 years and older, who were newly diagnosed with primary pancreatic cancer between 1991 and 1996 and who had a diagnostic laparoscopy or laparotomy during the course of their disease. Patients with a prior malignancy and those who had a pancreatic resection were excluded. We used proportional-hazards regression to adjust risk estimates for demographic factors, medical comorbidities, tumor characteristics, and the use of other treatment modalities. RESULTS: We identified 112 individuals with pancreatic cancer who had a laparoscopic procedure and 791 who had only conventional surgery. More patients who had laparoscopic surgery had distant metastases at diagnosis (67.9% vs 41.2%; P =.001). Median duration of survival in the laparoscopic surgery group was 4.8 months (95% confidence interval [CI], 4.1-6.8) compared with 5.3 months in the group that had only open surgery (95% CI, 4.9-5.6; P =.83). Compared with patients who only had a laparotomy, patients who had laparoscopic surgery did not have an increased rate of death when adjusted for the effects of age, sex, tumor size, grade, the presence of nodal and distant metastases at diagnosis, and the use of radiation, chemotherapy, therapeutic endoscopic retrograde cholangiopancreatography, and biliary and gastric bypass (adjusted hazard ratio, 0.93; 95% CI, 0.62-1.40). CONCLUSION: Exposure to laparoscopic surgery did not adversely affect survival in a cohort of elderly patients with pancreatic cancer who had a diagnostic procedure but no pancreatic resection.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.011
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.008

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.011
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.045
GPT teacher head0.337
Teacher spread0.292 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations20
Published2002
Admission routes1
Has abstractyes

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