Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group.
| العنوان: | Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group. |
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| المؤلفون: | Bond, M.J.G. |
| بيانات النشر: | 2023. |
| Added Details: | Kuiper, B.I. author. Bolhuis, K. author. Komurcu, A. author. Amerongen, M.J. van author. Chapelle, T. author. Dejong, C.H.C. author. Engelbrecht, M.R.W. author. Gerhards, M.F. author. Grünhagen, D.J. author. Gulik, T. van author. Hermans, J.J. author. Jong, K.P. de author. Klaase, J.M. author. Kok, N.F.M. author. Leclercq, W.K.G. author. Liem, M.S.L. author. Lienden, K.P. van author. Molenaar, I.Q. author. Neumann, U.P. author. Patijn, G.A. author. Rijken, A.M. author. Ruers, T.M. author. Verhoef, C. author. Wilt, J.H.W. de author. Kazemier, G. author. May, A.M. author. Punt, C.J.A. author. Swijnenburg, R.J. author. |
| وصف مادي: | 1 online resource |
| الموضوعات: | All institutes and research themes of the Radboud University Medical Center., Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences., Radboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences. |
| مصطلحات الفهرس: | Article / Letter to editor. |
| URL: | |
| الاتاحة: | Open access content. Open access content. |
| ملاحظة: | Annals of Surgical Oncology, 30, 9, pp. 5376-5385. Contains fulltext : 295971.pdf (Publisher's version ) (Open Access). BACKGROUND: Consensus on resectability criteria for colorectal cancer liver metastases (CRLM) is lacking, resulting in differences in therapeutic strategies. This study evaluated variability of resectability assessments and local treatment plans for patients with initially unresectable CRLM by the liver expert panel from the randomised phase III CAIRO5 study. METHODS: The liver panel, comprising surgeons and radiologists, evaluated resectability by predefined criteria at baseline and 2-monthly thereafter. If surgeons judged CRLM as resectable, detailed local treatment plans were provided. The panel chair determined the conclusion of resectability status and local treatment advice, and forwarded it to local surgeons. RESULTS: A total of 1149 panel evaluations of 496 patients were included. Intersurgeon disagreement was observed in 50% of evaluations and was lower at baseline than follow-up (36% vs. 60%, p < 0.001). Among surgeons in general, votes for resectable CRLM at baseline and follow-up ranged between 0-12% and 27-62%, and for permanently unresectable CRLM between 3-40% and 6-47%, respectively. Surgeons proposed different local treatment plans in 77% of patients. The most pronounced intersurgeon differences concerned the advice to proceed with hemihepatectomy versus parenchymal-preserving approaches. Eighty-four percent of patients judged by the panel as having resectable CRLM indeed received local treatment. Local surgeons followed the technical plan proposed by the panel in 40% of patients. CONCLUSION: Considerable variability exists among expert liver surgeons in assessing resectability and local treatment planning of initially unresectable CRLM. This stresses the value of panel-based decisions, and the need for consensus guidelines on resectability criteria and technical approach to prevent unwarranted variability in clinical practice. 01 september 2023. |
| Other Numbers: | NLQGE oai:repository.ubn.ru.nl:2066/295971 1443239569 |
| المصدر المساهم: | From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1443239569 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |