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The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
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Is it resectable? A survey regarding tumor classification and vascular involvement
Ahmer Irfan1, Wendy Feng2, Vikas Dudeja2
1Toronto General Hospital, Toronto, Canada.
Summary
Surgeons show significant variation in determining pancreatic cancer resectability, regardless of the classification system used. Concordance with chosen systems is also low, indicating a need for standardized approaches to pancreatic ductal adenocarcinoma (PDAC) treatment.
Area of Science:
- Hepatobiliary and Pancreatic Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Pancreatic ductal adenocarcinoma (PDAC) resectability is often challenged by the tumor's proximity to major vasculature.
- Standardized classification systems are crucial for consistent surgical decision-making in PDAC management.
Purpose of the Study:
- To investigate variations among HPB surgeons in determining PDAC resectability.
- To assess the concordance of surgeons with established classification systems for PDAC.
Main Methods:
- A multiple-choice survey was distributed to International HPB Association (IHPBA) members.
- Survey questions focused on surgeon demographics and clinical scenarios involving tumor resectability.
Main Results:
- 164 responses were analyzed, with most surgeons having over 10 years of experience.
- Significant variation was observed in how surgeons classified PDAC resectability across different scenarios (33.5%-84.7%).
- Surgeons' concordance with their stated classification systems was low (median 62.5%), and resectability decisions were independent of the system used.
Conclusions:
- There is substantial variability in how HPB surgeons classify PDAC resectability.
- Surgeons exhibit low concordance with the definitions of the classification systems they employ.
- Standardization of PDAC resectability assessment is needed to improve consistency in surgical practice.
