Jakob Kirkegård

Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • J. Kirkegard
  • E. K. Aahlin, Univ Hosp Northern Norway, UiT The Arctic University of Tromso, University Hospital of North Norway, Dept Gastrointestinal & HPB Surg
  • ,
  • M. Al-Saiddi, Stavanger Univ Hosp, Stavanger University Hospital, Dept Radiol
  • ,
  • S. O. Bratlie, Sahlgrens Univ Hosp, Sahlgrenska University Hospital, Dept Surg
  • ,
  • M. Coolsen, Maastricht Univ, Maastricht University, Med Ctr, Dept Surg
  • ,
  • R. J. de Haas, Univ Med Ctr Groningen, University of Groningen, Dept Radiol
  • ,
  • M. den Dulk, Univ Hosp RWTH Aachen, RWTH Aachen University, Dept Thorac & Cardiovasc Surg
  • ,
  • C. Fristrup, Odense Univ Hosp, Odense University Hospital, Dept Surg Gastroenterol, Odense Pancreas Ctr
  • ,
  • E. M. Harrison, Royal Infirm Edinburgh NHS Trust, Royal Infirmary of Edinburgh, University of Edinburgh, Clin Surg
  • ,
  • M. B. Mortensen, Odense Univ Hosp, Odense University Hospital, Dept Surg Gastroenterol, Odense Pancreas Ctr
  • ,
  • M. W. Nijkamp, Univ Med Ctr Groningen, University of Groningen, Dept Surg Oncol
  • ,
  • J. Persson, Sahlgrens Univ Hosp, Sahlgrenska University Hospital, Dept Surg
  • ,
  • J. A. Soreide, Univ Bergen, University of Bergen, Dept Clin Med, Inst Med & Dent, Stavanger University Hospital, Stavanger
  • ,
  • S. J. Wigmore, Royal Infirm Edinburgh NHS Trust, Royal Infirmary of Edinburgh, University of Edinburgh, Clin Surg
  • ,
  • T. Wik, Univ Hosp Northern Norway, UiT The Arctic University of Tromso, University Hospital of North Norway, Dept Radiol
  • ,
  • F. V. Mortensen

Background: Multidisciplinary team (MDT) meetings have been adopted widely to ensure optimal treatment for patients with cancer. Agreements in tumour staging, resectability assessments and treatment allocation between different MDTs were assessed. Methods: Of all patients referred to one hospital, 19 patients considered to have non-metastatic pancreatic cancer for evaluation were selected randomly for a multicentre study of MDT decisions in seven units across Northern Europe. Anonymized clinical information and radiological images were disseminated to the MDTs. All patients were reviewed by the MDTs for radiological T, N and M category, resectability assessment and treatment allocation. Each MDT was blinded to the decisions of other teams. Agreements were expressed as raw percentages and Krippendorff's α values, both with 95 per cent confidence intervals. Results: A total of 132 evaluations in 19 patients were carried out by the seven MDTs (1 evaluation was excluded owing to technical problems). The level of agreement for T, N and M categories ranged from moderate to near perfect (46·8, 61·1 and 82·8 per cent respectively), but there was substantial variation in assessment of resectability; seven patients were considered to be resectable by one MDT but unresectable by another. The MDTs all agreed on either a curative or palliative strategy in less than half of the patients (9 of 19). Only fair agreement in treatment allocation was observed (Krippendorff's α 0·31, 95 per cent c.i. 0·16 to 0·45). There was a high level of agreement in treatment allocation where resectability assessments were concordant. Conclusion: Considerable disparities in MDT evaluations of patients with pancreatic cancer exist, including substantial variation in resectability assessments.

Original languageEnglish
JournalBritish Journal of Surgery
Volume106
Issue6
Pages (from-to)756-764
Number of pages9
ISSN1365-2168
DOIs
Publication statusPublished - May 2019

    Research areas

  • CONSENSUS, GEMCITABINE, MANAGEMENT, CRITERIA

See relations at Aarhus University Citationformats

Activities

  • 2nd North Sea HPB Meeting

    Activity: Participating in or organising an event typesParticipation in or organisation af a conference

  • 5th Scandinavian HPB Meeting

    Activity: Participating in or organising an event typesParticipation in or organisation af a conference

  • 1st North Sea HPB Meeting

    Activity: Participating in or organising an event typesParticipation in or organisation af a conference

Projects

ID: 137140840