Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey
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.
| 2023 | |
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NEOPLASIAS PANCREÁTICAS PRONÓSTICO TERAPÉUTICA TOMOGRAFÍA |
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| 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) |
| _version_ | 1875692816026304512 |
|---|---|
| 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. |
| dc.format.extent.es.fl_str_mv | 9 p. |
| dc.format.mimetype.es.fl_str_mv | application/pdf |
| 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 |
| format | article |
| id | COLIBRI_8a2b384597ac2ebca41d987b69ec24dd |
| 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 |
| instacron_str | Universidad de la República |
| institution | Universidad de la República |
| instname_str | Universidad de la República |
| language | eng |
| language_invalid_str_mv | en |
| network_acronym_str | COLIBRI |
| network_name_str | COLIBRI |
| oai_identifier_str | oai:colibri.udelar.edu.uy:20.500.12008/52137 |
| publishDate | 2023 |
| reponame_str | COLIBRI |
| repository.mail.fl_str_mv | karina.camps@seciu.edu.uy |
| repository.name.fl_str_mv | COLIBRI - Universidad de la República |
| repository_id_str | 4771 |
| 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 |