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

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

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    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.

    Originele taal-2English
    Pagina's (van-tot)1402-1408
    Aantal pagina's7
    TijdschriftJournal of Surgical Oncology
    Volume124
    Nummer van het tijdschrift8
    Vroegere onlinedatum7-sep-2021
    DOI's
    StatusPublished - 15-dec-2021

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