Consensus in determining the resectability of locally progressed pancreatic ductal adenocarcinoma - results of the Conko-007 multicenter trial

One critical step in the therapy of patients with localized pancreatic cancer is the determination of local resectability. The decision between primary surgery versus upfront local or systemic cancer therapy seems especially to differ between pancreatic cancer centers. In our cohort study, we analyz...

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Bibliographic Details
Published in:BMC cancer 2019-10, Vol.19 (1), p.979-979, Article 979
Main Authors: Wittel, U A, Lubgan, D, Ghadimi, M, Belyaev, O, Uhl, W, Bechstein, W O, Grützmann, R, Hohenberger, W M, Schmid, A, Jacobasch, L, Croner, R S, Reinacher-Schick, A, Hopt, U T, Pirkl, A, Oettle, H, Fietkau, R, Golcher, H
Format: Article
Language:English
Subjects:
Borderline resectable
Carcinoma, Pancreatic Ductal - diagnostic imaging
Carcinoma, Pancreatic Ductal - surgery
Consensus
Determination of resectability
Germany
Humans
Locally advanced
Magnetic Resonance Imaging
Pancreatectomy
Pancreatic cancer
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - surgery
Prospective randomized multicenter trial
Prospective Studies
Surgeons - psychology
Tomography, X-Ray Computed
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Summary:One critical step in the therapy of patients with localized pancreatic cancer is the determination of local resectability. The decision between primary surgery versus upfront local or systemic cancer therapy seems especially to differ between pancreatic cancer centers. In our cohort study, we analyzed the independent judgement of resectability of five experienced high volume pancreatic surgeons in 200 consecutive patients with borderline resectable or locally advanced pancreatic cancer. Pretherapeutic CT or MRI scans of 200 consecutive patients with borderline resectable or locally advanced pancreatic cancer were evaluated by 5 independent pancreatic surgeons. Resectability and the degree of abutment of the tumor to the venous and arterial structures adjacent to the pancreas were reported. Interrater reliability and dispersion indices were compared. One hundred ninety-four CT scans and 6 MRI scans were evaluated and all parameters were evaluated by all surgeons in 133 (66.5%) cases. Low agreement was observed for tumor infiltration of venous structures (κ = 0.265 and κ = 0.285) while good agreement was achieved for the abutment of the tumor to arterial structures (interrater reliability celiac trunk κ = 0.708 P 
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-019-6148-5