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Record W2333550047 · doi:10.1097/coc.0b013e3182a533ea

Pancreatectomy Versus Conservative Management for Pancreatic Cancer

2013· article· en· W2333550047 on OpenAlexaff
Wayne S. Kendal

Bibliographic record

VenueAmerican Journal of Clinical Oncology · 2013
Typearticle
Languageen
FieldMedicine
TopicPancreatic and Hepatic Oncology Research
Canadian institutionsOttawa HospitalUniversity of Ottawa
Fundersnot available
KeywordsMedicinePancreatic cancerPancreatectomyCohortOccultCancerPopulationSurgeryPancreasStage (stratigraphy)Survival analysisInternal medicinePathology

Abstract

fetched live from OpenAlex

OBJECTIVES: Pancreatectomy is regarded as the only curative treatment for cancer of the pancreas. A population-based study was conducted to examine its efficacy within the general community. METHODS: Overall and cancer-specific survivals were compared between individuals treated with pancreatectomy and those managed nonsurgically. Kaplan-Meier analysis was used, based on both time from diagnosis and attained age (age at diagnosis plus time from diagnosis). RESULTS: A total of 7830 Surveillance Epidemiology and End Results cases of localized cancer of the pancreatic head were retrieved, diagnosed from 2000 to 2008. Median follow-up was 12 months; the pancreatectomy cohort was 5 years younger and had 7-fold less stage III disease. Overall and cancer-specific survivals were 17% and 21% at 5 years from time of diagnosis in the pancreatectomy cohort versus 2% and 4% in the nonsurgical cohort, respectively (P<0.001). However, the overall and cancer-specific survival curves were nearly superimposed on each other when based on attained age. Moreover, the proportion of deaths attributable to pancreatic cancer exceeded 85% in both cohorts. CONCLUSIONS: A lead-time bias is hypothesized to explain the survival discrepancies seen between time from diagnosis and attained age analyses; the pancreatectomy cohort was diagnosed earlier, with less disease. If most of these individuals had occult metastases at diagnosis, which manifested later and caused death at similar ages as the nonsurgical cohort, their survival from time of diagnosis would appear speciously improved. A randomized controlled trial would be necessary to confirm whether or not the survival advantage ascribed to pancreatectomy should be attributed to lead-time bias.

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)0.001
metaresearch head score (Gemma)0.003
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: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.010

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0030.000

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 head0.160
GPT teacher head0.522
Teacher spread0.362 · 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

Citations2
Published2013
Admission routes1
Has abstractyes

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