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Determination of "borderline resectable" pancreatic cancer - A global assessment of 30 shades of grey.
Badgery, Henry E; Muhlen-Schulte, Tjuntu; Zalcberg, John R; D'souza, Bianka; Gerstenmaier, Jan F; Pickett, Craig; Samra, Jaswinder; Croagh, Daniel.
Afiliação
  • Badgery HE; Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Surgery, The University of Melbourne, St Vincent's Hospital, Melbourne, Australia.
  • Muhlen-Schulte T; Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia.
  • Zalcberg JR; Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia; Department of Oncology, Alfred Health, Melbourne, Victoria, Australia.
  • D'souza B; Cancer Research Program, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia.
  • Gerstenmaier JF; Department of Radiology, Alfred Health, Melbourne, Australia.
  • Pickett C; Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine Monash University, Melbourne, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.
  • Samra J; Department of Upper GI Surgery, Royal North Shore Hospital, NSW, Australia.
  • Croagh D; Department of Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia; Monash Health, Melbourne, Victoria, Australia. Electronic address: daniel.croagh@monash.edu.
HPB (Oxford) ; 25(11): 1393-1401, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37558564
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis. Accurate preoperative assessment using computed tomography (CT) to determine resectability is crucial in ensuring patients are offered the most appropriate therapeutic strategy. Despite the use of classification guidelines, any interobserver variability between reviewing surgeons and radiologists may confound decisions influencing patient treatment pathways. METHODS: In this multicentre observational study, an international group of 96 clinicians (42 hepatopancreatobiliary surgeons and 54 radiologists) were surveyed and asked to report 30 pancreatic CT scans of pancreatic cancer deemed borderline at respective multidisciplinary meetings (MDM). The degree of interobserver agreement in resectability among radiologists and surgeons was assessed and subgroup regression analysis was performed. RESULTS: Interobserver variability between reviewers was high with no unanimous agreement. Overall interobserver agreement was fair with a kappa value of 0.32 with a higher rate of agreement among radiologists over surgeons. CONCLUSION: Interobserver variability among radiologists and surgeons globally is high, calling into question the consistency of clinical decision making for patients with PDAC and suggesting that central review may be required for studies of neoadjuvant or adjuvant approaches in future as well as ongoing quality control initiatives, even amongst experts in the field.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Adenocarcinoma / Carcinoma Ductal Pancreático Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Adenocarcinoma / Carcinoma Ductal Pancreático Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article