Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients

Jakob Kirkegard; Mohammed Al-Saiddi; Svein Olav Bratlie; Marielle Coolsen; Robbert J. de Haas; Marcel den Dulk; Claus Fristrup; Ole Jacob Greve; Ewen Harrison; Giasemi Koutouzi; Razvan L. Miclea; Michael B. Mortensen; Maarten W. Nijkamp; Jan Persson; Francis P. Robertson; Jules J. G. Slangen; Jon Arne Søreide; Stephen J. Wigmore; Frank V. Mortensen

doi:10.1002/jso.26670

Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients

Jakob Kirkegard^*, Mohammed Al-Saiddi, Svein Olav Bratlie, Marielle Coolsen, Robbert J. de Haas, Marcel den Dulk, Claus Fristrup, Ole Jacob Greve, Ewen Harrison, Giasemi Koutouzi, Razvan L. Miclea, Michael B. Mortensen, Maarten W. Nijkamp, Jan Persson, Francis P. Robertson, Jules J. G. Slangen, Jon Arne Søreide, Stephen J. Wigmore, Frank V. Mortensen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background and Methods

Treatment strategies for pancreatic cancer patients are made by a multidisciplinary team (MDT) board. We aimed to assess intra-observer variance at MDT boards. Participating units staged, assessed resectability, and made treatment allocations for the same patients as they did two years earlier. We disseminated clinical information and CT images of pancreatic cancer patients judged by one MDT board to have nonmetastatic pancreatic cancer to the participating units. All units were asked to re-assess the TNM stage, resectability, and treatment allocation for each patient. To assess intra-observer variance, we computed %-agreements for each participating unit, defined as low (75%) agreement.

Results

Eighteen patients were re-assessed by six MDT boards. The overall agreement was moderate for TNM-stage (ranging from 50%-70%) and resectability assessment (53%) but low for treatment allocation (46%). Agreement on resectability assessments was low to moderate. Findings were similar but more pronounced for treatment allocation. We observed a shift in treatment strategy towards increasing use of neoadjuvant chemotherapy, particularly in patients with borderline resectable and locally advanced tumors.

Conclusions

We found substantial intra-observer agreement variations across six different MDT boards of 18 pancreatic cancer patients with two years between the first and second assessment.

Original language	English
Pages (from-to)	1402-1408
Number of pages	7
Journal	Journal of Surgical Oncology
Volume	124
Issue number	8
Early online date	7-Sept-2021
DOIs	https://doi.org/10.1002/jso.26670
Publication status	Published - 15-Dec-2021

Keywords

neoadjuvant chemotherapy
pancreatic cancer
resectability
treatment allocation
variation
TUMOR BOARD
MANAGEMENT

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10.1002/jso.26670

Intra‐observer agreements in multidisciplinary teamFinal publisher's version, 986 KBLicence: Taverne

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Kirkegard, J., Al-Saiddi, M., Bratlie, S. O., Coolsen, M., de Haas, R. J., den Dulk, M., Fristrup, C., Greve, O. J., Harrison, E., Koutouzi, G., Miclea, R. L., Mortensen, M. B., Nijkamp, M. W., Persson, J., Robertson, F. P., Slangen, J. J. G., Søreide, J. A., Wigmore, S. J., & Mortensen, F. V. (2021). Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients. Journal of Surgical Oncology, 124(8), 1402-1408. https://doi.org/10.1002/jso.26670

@article{4371ded6f0d849188c3fa5a3e13a3df8,

title = "Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients",

abstract = "Background and Methods Treatment strategies for pancreatic cancer patients are made by a multidisciplinary team (MDT) board. We aimed to assess intra-observer variance at MDT boards. Participating units staged, assessed resectability, and made treatment allocations for the same patients as they did two years earlier. We disseminated clinical information and CT images of pancreatic cancer patients judged by one MDT board to have nonmetastatic pancreatic cancer to the participating units. All units were asked to re-assess the TNM stage, resectability, and treatment allocation for each patient. To assess intra-observer variance, we computed %-agreements for each participating unit, defined as low (75%) agreement. Results Eighteen patients were re-assessed by six MDT boards. The overall agreement was moderate for TNM-stage (ranging from 50%-70%) and resectability assessment (53%) but low for treatment allocation (46%). Agreement on resectability assessments was low to moderate. Findings were similar but more pronounced for treatment allocation. We observed a shift in treatment strategy towards increasing use of neoadjuvant chemotherapy, particularly in patients with borderline resectable and locally advanced tumors. Conclusions We found substantial intra-observer agreement variations across six different MDT boards of 18 pancreatic cancer patients with two years between the first and second assessment.",

keywords = "neoadjuvant chemotherapy, pancreatic cancer, resectability, treatment allocation, variation, TUMOR BOARD, MANAGEMENT",

author = "Jakob Kirkegard and Mohammed Al-Saiddi and Bratlie, {Svein Olav} and Marielle Coolsen and {de Haas}, {Robbert J.} and {den Dulk}, Marcel and Claus Fristrup and Greve, {Ole Jacob} and Ewen Harrison and Giasemi Koutouzi and Miclea, {Razvan L.} and Mortensen, {Michael B.} and Nijkamp, {Maarten W.} and Jan Persson and Robertson, {Francis P.} and Slangen, {Jules J. G.} and S{\o}reide, {Jon Arne} and Wigmore, {Stephen J.} and Mortensen, {Frank V.}",

year = "2021",

month = dec,

day = "15",

doi = "10.1002/jso.26670",

language = "English",

volume = "124",

pages = "1402--1408",

journal = "Journal of Surgical Oncology",

issn = "0022-4790",

publisher = "Wiley",

number = "8",

}

Kirkegard, J, Al-Saiddi, M, Bratlie, SO, Coolsen, M, de Haas, RJ, den Dulk, M, Fristrup, C, Greve, OJ, Harrison, E, Koutouzi, G, Miclea, RL, Mortensen, MB, Nijkamp, MW, Persson, J, Robertson, FP, Slangen, JJG, Søreide, JA, Wigmore, SJ & Mortensen, FV 2021, 'Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients', Journal of Surgical Oncology, vol. 124, no. 8, pp. 1402-1408. https://doi.org/10.1002/jso.26670

TY - JOUR

T1 - Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients

AU - Kirkegard, Jakob

AU - Al-Saiddi, Mohammed

AU - Bratlie, Svein Olav

AU - Coolsen, Marielle

AU - de Haas, Robbert J.

AU - den Dulk, Marcel

AU - Fristrup, Claus

AU - Greve, Ole Jacob

AU - Harrison, Ewen

AU - Koutouzi, Giasemi

AU - Miclea, Razvan L.

AU - Mortensen, Michael B.

AU - Nijkamp, Maarten W.

AU - Persson, Jan

AU - Robertson, Francis P.

AU - Slangen, Jules J. G.

AU - Søreide, Jon Arne

AU - Wigmore, Stephen J.

AU - Mortensen, Frank V.

PY - 2021/12/15

Y1 - 2021/12/15

N2 - Background and Methods Treatment strategies for pancreatic cancer patients are made by a multidisciplinary team (MDT) board. We aimed to assess intra-observer variance at MDT boards. Participating units staged, assessed resectability, and made treatment allocations for the same patients as they did two years earlier. We disseminated clinical information and CT images of pancreatic cancer patients judged by one MDT board to have nonmetastatic pancreatic cancer to the participating units. All units were asked to re-assess the TNM stage, resectability, and treatment allocation for each patient. To assess intra-observer variance, we computed %-agreements for each participating unit, defined as low (75%) agreement. Results Eighteen patients were re-assessed by six MDT boards. The overall agreement was moderate for TNM-stage (ranging from 50%-70%) and resectability assessment (53%) but low for treatment allocation (46%). Agreement on resectability assessments was low to moderate. Findings were similar but more pronounced for treatment allocation. We observed a shift in treatment strategy towards increasing use of neoadjuvant chemotherapy, particularly in patients with borderline resectable and locally advanced tumors. Conclusions We found substantial intra-observer agreement variations across six different MDT boards of 18 pancreatic cancer patients with two years between the first and second assessment.

AB - Background and Methods Treatment strategies for pancreatic cancer patients are made by a multidisciplinary team (MDT) board. We aimed to assess intra-observer variance at MDT boards. Participating units staged, assessed resectability, and made treatment allocations for the same patients as they did two years earlier. We disseminated clinical information and CT images of pancreatic cancer patients judged by one MDT board to have nonmetastatic pancreatic cancer to the participating units. All units were asked to re-assess the TNM stage, resectability, and treatment allocation for each patient. To assess intra-observer variance, we computed %-agreements for each participating unit, defined as low (75%) agreement. Results Eighteen patients were re-assessed by six MDT boards. The overall agreement was moderate for TNM-stage (ranging from 50%-70%) and resectability assessment (53%) but low for treatment allocation (46%). Agreement on resectability assessments was low to moderate. Findings were similar but more pronounced for treatment allocation. We observed a shift in treatment strategy towards increasing use of neoadjuvant chemotherapy, particularly in patients with borderline resectable and locally advanced tumors. Conclusions We found substantial intra-observer agreement variations across six different MDT boards of 18 pancreatic cancer patients with two years between the first and second assessment.

KW - neoadjuvant chemotherapy

KW - pancreatic cancer

KW - resectability

KW - treatment allocation

KW - variation

KW - TUMOR BOARD

KW - MANAGEMENT

U2 - 10.1002/jso.26670

DO - 10.1002/jso.26670

M3 - Article

SN - 0022-4790

VL - 124

SP - 1402

EP - 1408

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 8

ER -

Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients

Abstract

Keywords

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