Related Experiment Video
Updated: Jan 13, 2026
An Orthotopic Resectional Mouse Model of Pancreatic Cancer
Published on: September 24, 2020
Synoptic Multidisciplinary Team Meeting Workflows to Promote Guideline-Based Classification of Resectability in
William McGahan1,2,3, Nick Butler2,3, Thomas O'Rourke2,3
1Department of General Surgery, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Purpose:
To address incomplete and inconsistent classification of pancreatic cancer resectability according to International Association of Pancreatology (IAP) anatomic, biologic, and conditional criteria.
Materials And Methods:
We designed, implemented, and evaluated an interoperable, web-based platform that captured structured pretreatment data and performed algorithm-driven resectability classification. Linked modules supported referral to and discussion at multidisciplinary team meetings (MDTMs) at two quaternary hospitals (June 2021-February 2022) and populated downstream documentation. In a pre-post study, Pearson χ2 test and multivariable logistic regression (odds ratios [ORs] with 95% CI) compared data completeness (primary end point), as well as the distribution of IAP-defined resectability and treatment intent (secondary end points). In the postintervention cohort, overall survival (OS) was stratified by IAP resectability using Kaplan-Meier curves and compared using the log-rank test. Hazard ratios (HRs) with 95% CIs and log-rank statistics were calculated for individual resectability criteria using Cox models. All tests were two-sided with nominal significance (P < .05). An embedded module evaluated workflow integration and user experience.
Results:
Ninety-five patients with pancreatic cancer were referred to MDTMs during the intervention period, of whom 71 were eligible. Compared with 71 preintervention patients, the system improved documentation of tumor-vessel relationships (OR, 9.39 [95% CI, 4.43 to 21.7]), locoregional lymphadenopathy (OR, 30.5 [95% CI, 11.1 to 102]), and performance status (PS; OR, 3.34 [95% CI, 1.67 to 6.85]), reducing the number with unknown resectability (OR, 0.10 [95% CI, 0.03 to 0.25]). PS ≥ 2 (HR, 2.16 [95% CI, 1.06 to 4.43]) and serum CA19.9 ≥ 500 U/mL (HR, 1.94 [95% CI, 1.03 to 3.63]) were significantly associated with OS, whereas anatomic criteria were not.
Discussion:
A synoptic intervention integrated into MDTM workflows across multiple sites improved structured data capture, reduced unknown resectability, and highlighted the relevance of biologic and conditional criteria in addition to tumor anatomy.
