Evidence map›Paper›PMID 33817647›Full record

Observational studyRadiology. Imaging cancer2021

The Role of CT in Assessment of Extraregional Lymph Node Involvement in Pancreatic and Periampullary Cancer: A Diagnostic Accuracy Study.

Dorine S J Tseng, Bobby K Pranger, Maarten S van Leeuwen, Jan Pieter Pennings, Lodewijk A Brosens, Nadja Haj Mohammad, Vincent E de Meijer, Hjalmar C van Santvoort, Joris I Erdmann, I Quintus Molenaar

Open access · diamondAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Radiology. Imaging cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
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  6. Clinical significance and efficacy of endoscopic ultrasound-guided tissue acquisition for para-aortic lymph node metastasis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Dorine S J TsengDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).ORCID 0000-0002-6021-580X
Bobby K PrangerDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).ORCID 0000-0002-6304-7987
Maarten S van LeeuwenDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
Jan Pieter PenningsDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
Lodewijk A BrosensDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).ORCID 0000-0003-1341-8994
Nadja Haj MohammadDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
Vincent E de MeijerDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
Hjalmar C van SantvoortDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
Joris I ErdmannDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
I Quintus MolenaarDepartment of Surgery, University Medical Center Utrecht and St Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Heidelberglaan 100, HG G04.228, PO Box 85500, 3508 GA, Utrecht, the Netherlands (D.S.J.T., H.C.v.S., I.Q.M.); University of Groningen and University Medical Center Groningen, Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Groningen, the Netherlands (B.K.P., V.E.d.M., J.I.E.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (M.S.v.L.); University of Groningen and University Medical Center Groningen, Department of Radiology, Groningen, the Netherlands (J.P.P.); Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands (L.A.B.); Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (N.H.M.).
University Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: To investigate the diagnostic accuracy of CT in assessing extraregional lymph node metastases in pancreatic head and periampullary cancer. Materials and Methods: This prospective observational cohort study was performed at two tertiary hepatopancreatobiliary (HPB) referral centers between March 2013 and December 2014. Patients undergoing pancreatoduodenectomy or bypass surgery with or without palliative radiofrequency ablation were included. Extraregional lymph node involvement was defined as positive lymph nodes in the aortocaval window. Two expert HPB radiologists assessed aortocaval lymph nodes at preoperative CT according to a standardized protocol. All tissue from the aortocaval window was collected intraoperatively. Positive histopathologic finding was the reference standard. Analysis of predictive values and diagnostic accuracy was performed. Results: A total of 198 consecutive patients (mean age, 66 years; range, 39-86 years; 105 men) with pancreatic head or periampullary carcinoma were included. In 70% of patients, a pancreatoduodenectomy was performed, 4% underwent total pancreatectomy, 4% underwent radiofrequency ablation, and 22% underwent bypass surgery. Forty-four patients (22%) had histologically positive aortocaval lymph nodes. Negative predictive value of CT in assessing aortocaval lymph nodes was 80% for both observers, and positive predictive value was 31%-33%. Overall diagnostic accuracy was 69%-70%. Conclusion: CT has a low diagnostic accuracy in assessing extraregional lymph node metastases in patients suspected of having pancreatic or periampullary cancer.

Indexed as

Duodenal NeoplasmsAgedCohort StudiesHumansLymph NodesMalePancreasProspective StudiesTomography, X-Ray ComputedAbdomen/GICTOncologyPancreas

Identifiers

PMID33817647
PMCPMC8011448
OpenAlexW3135957644

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.