Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey

Badgery, Henry E. - Muhlen-Schulte, Tjuntu - Zalcberg, John Raymond - D'souza, Bianka - Gerstenmaier, Jan F. - Pickett, Craig - Samara, Jaswinder Singh - Croagh, Daniel G. - Ahmed, Farhan - Allan, Emel - Amelina, Inna - Aroori, Somaiah - Balendran, Nalayini - Chu, Linda C.H. - Carnelli, Carlos

Resumen:

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.

Detalles Bibliográficos
2023
NEOPLASIAS PANCREÁTICAS
PRONÓSTICO
TERAPÉUTICA
TOMOGRAFÍA
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/52137
Acceso abierto
Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
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author Badgery, Henry E.
author2 Muhlen-Schulte, Tjuntu
Zalcberg, John Raymond
D'souza, Bianka
Gerstenmaier, Jan F.
Pickett, Craig
Samara, Jaswinder Singh
Croagh, Daniel G.
Ahmed, Farhan
Allan, Emel
Amelina, Inna
Aroori, Somaiah
Balendran, Nalayini
Chu, Linda C.H.
Carnelli, Carlos
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author_facet Badgery, Henry E.
Muhlen-Schulte, Tjuntu
Zalcberg, John Raymond
D'souza, Bianka
Gerstenmaier, Jan F.
Pickett, Craig
Samara, Jaswinder Singh
Croagh, Daniel G.
Ahmed, Farhan
Allan, Emel
Amelina, Inna
Aroori, Somaiah
Balendran, Nalayini
Chu, Linda C.H.
Carnelli, Carlos
author_role author
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collection COLIBRI
dc.contributor.filiacion.none.fl_str_mv Badgery Henry E., University of Melbourne (Australia). Department of Surgery
Muhlen-Schulte Tjuntu, Monash University (Australia)
Zalcberg John Raymond, Monash University (Australia)
D'souza Bianka, Monash University (Australia)
Gerstenmaier Jan F., Alfred Health (Australia). Department of Radiology
Pickett Craig, Monash University (Australia)
Samara Jaswinder Singh, Royal North Shore Hospital (Australia)
Croagh Daniel G., Monash University (Australia)
Ahmed Farhan, The Northern Hospital (Australia). Department of Radiology
Allan Emel, South Coast Radiology (Australia). Radiology Department
Amelina Inna, National Medical Research Center of Oncology (Rusia)
Aroori Somaiah, University Hospitals Plymouth NHS Trust (Reino Unido)
Balendran Nalayini, St. George Hospital (Australia). Department of Radiology
Chu Linda C.H., Johns Hopkins University School of Medicine (E.E.U.U.)
Carnelli Carlos, Universidad de la República (Uruguay). Facultad de Medicina
dc.creator.none.fl_str_mv Badgery, Henry E.
Muhlen-Schulte, Tjuntu
Zalcberg, John Raymond
D'souza, Bianka
Gerstenmaier, Jan F.
Pickett, Craig
Samara, Jaswinder Singh
Croagh, Daniel G.
Ahmed, Farhan
Allan, Emel
Amelina, Inna
Aroori, Somaiah
Balendran, Nalayini
Chu, Linda C.H.
Carnelli, Carlos
dc.date.accessioned.none.fl_str_mv 2025-10-17T17:08:11Z
dc.date.available.none.fl_str_mv 2025-10-17T17:08:11Z
dc.date.issued.none.fl_str_mv 2023
dc.description.abstract.none.fl_txt_mv 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.
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dc.identifier.citation.es.fl_str_mv Badgery H, Muhlen-Schulte T, Zalcberg J y otros. Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey. HPB [en línea] . Nov. 2023;25(11):1393-1401
dc.identifier.doi.none.fl_str_mv 10.1016/j.hpb.2023.07.883
dc.identifier.issn.none.fl_str_mv 1477-2574
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12008/52137
dc.language.iso.none.fl_str_mv en
eng
dc.publisher.es.fl_str_mv Elsevier
dc.relation.none.fl_str_mv HPB. Nov. 2023;25(11):1393-1401
dc.rights.license.none.fl_str_mv Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
dc.source.none.fl_str_mv reponame:COLIBRI
instname:Universidad de la República
instacron:Universidad de la República
dc.subject.other.es.fl_str_mv NEOPLASIAS PANCREÁTICAS
PRONÓSTICO
TERAPÉUTICA
TOMOGRAFÍA
dc.title.none.fl_str_mv Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
dc.type.es.fl_str_mv Artículo
dc.type.none.fl_str_mv info:eu-repo/semantics/article
dc.type.version.none.fl_str_mv info:eu-repo/semantics/publishedVersion
description 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.
eu_rights_str_mv openAccess
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identifier_str_mv Badgery H, Muhlen-Schulte T, Zalcberg J y otros. Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey. HPB [en línea] . Nov. 2023;25(11):1393-1401
1477-2574
10.1016/j.hpb.2023.07.883
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repository.mail.fl_str_mv karina.camps@seciu.edu.uy
repository.name.fl_str_mv COLIBRI - Universidad de la República
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rights_invalid_str_mv Licencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)
spelling Badgery Henry E., University of Melbourne (Australia). Department of SurgeryMuhlen-Schulte Tjuntu, Monash University (Australia)Zalcberg John Raymond, Monash University (Australia)D'souza Bianka, Monash University (Australia)Gerstenmaier Jan F., Alfred Health (Australia). Department of RadiologyPickett Craig, Monash University (Australia)Samara Jaswinder Singh, Royal North Shore Hospital (Australia)Croagh Daniel G., Monash University (Australia)Ahmed Farhan, The Northern Hospital (Australia). Department of RadiologyAllan Emel, South Coast Radiology (Australia). Radiology DepartmentAmelina Inna, National Medical Research Center of Oncology (Rusia)Aroori Somaiah, University Hospitals Plymouth NHS Trust (Reino Unido)Balendran Nalayini, St. George Hospital (Australia). Department of RadiologyChu Linda C.H., Johns Hopkins University School of Medicine (E.E.U.U.)Carnelli Carlos, Universidad de la República (Uruguay). Facultad de Medicina2025-10-17T17:08:11Z2025-10-17T17:08:11Z2023Badgery H, Muhlen-Schulte T, Zalcberg J y otros. Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey. HPB [en línea] . Nov. 2023;25(11):1393-14011477-2574https://hdl.handle.net/20.500.12008/5213710.1016/j.hpb.2023.07.883Background: 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.Submitted by Almiñana María Cecilia (marialminana@gmail.com) on 2025-10-08T18:20:27Z No. of bitstreams: 2 license_rdf: 26539 bytes, checksum: 3b50ae24bd8bd076d49a70878a8a2d2c (MD5) Determination of borderline resectable pancreatic cancer.pdf: 785985 bytes, checksum: 2d06a7a4df64bfdda945ccb2fad521cc (MD5)Approved for entry into archive by Almiñana María Cecilia (marialminana@gmail.com) on 2025-10-14T16:11:05Z (GMT) No. of bitstreams: 2 license_rdf: 26539 bytes, checksum: 3b50ae24bd8bd076d49a70878a8a2d2c (MD5) Determination of borderline resectable pancreatic cancer.pdf: 785985 bytes, checksum: 2d06a7a4df64bfdda945ccb2fad521cc (MD5)Made available in DSpace by Luna Fabiana (fabiana.luna@seciu.edu.uy) on 2025-10-17T17:08:11Z (GMT). No. of bitstreams: 2 license_rdf: 26539 bytes, checksum: 3b50ae24bd8bd076d49a70878a8a2d2c (MD5) Determination of borderline resectable pancreatic cancer.pdf: 785985 bytes, checksum: 2d06a7a4df64bfdda945ccb2fad521cc (MD5) Previous issue date: 20239 p.application/pdfenengElsevierHPB. Nov. 2023;25(11):1393-1401Las obras depositadas en el Repositorio se rigen por la Ordenanza de los Derechos de la Propiedad Intelectual de la Universidad de la República.(Res. Nº 91 de C.D.C. de 8/III/1994 – D.O. 7/IV/1994) y por la Ordenanza del Repositorio Abierto de la Universidad de la República (Res. Nº 16 de C.D.C. de 07/10/2014)info:eu-repo/semantics/openAccessLicencia Creative Commons Atribución - No Comercial - Sin Derivadas (CC - By-NC-ND 4.0)NEOPLASIAS PANCREÁTICASPRONÓSTICOTERAPÉUTICATOMOGRAFÍADetermination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of greyArtículoinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:COLIBRIinstname:Universidad de la Repúblicainstacron:Universidad de la RepúblicaBadgery, Henry E.Muhlen-Schulte, TjuntuZalcberg, John RaymondD'souza, BiankaGerstenmaier, Jan F.Pickett, CraigSamara, Jaswinder SinghCroagh, Daniel G.Ahmed, FarhanAllan, EmelAmelina, InnaAroori, SomaiahBalendran, NalayiniChu, Linda C.H.Carnelli, CarlosLICENSElicense.txtlicense.txttext/plain; charset=utf-84267http://localhost:8080/xmlui/bitstream/20.500.12008/52137/5/license.txt6429389a7df7277b72b7924fdc7d47a9MD55CC-LICENSElicense_urllicense_urltext/plain; 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- Universidad de la Repúblicafalse
spellingShingle Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
Badgery, Henry E.
NEOPLASIAS PANCREÁTICAS
PRONÓSTICO
TERAPÉUTICA
TOMOGRAFÍA
status_str publishedVersion
title Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
title_full Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
title_fullStr Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
title_full_unstemmed Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
title_short Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
title_sort Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
topic NEOPLASIAS PANCREÁTICAS
PRONÓSTICO
TERAPÉUTICA
TOMOGRAFÍA
url https://hdl.handle.net/20.500.12008/52137