Evidence map›Paper›PMID 36774435›Full record

ArticleAnnals of surgical oncology2023

Intraoperative Ultrasound During Surgical Exploration in Patients with Pancreatic Cancer and Vascular Involvement (ULTRAPANC): A Prospective Multicenter Study.

Nynke Michiels, Deesje Doppenberg, Jesse V Groen, Eran van Veldhuisen, Bert A Bonsing, Olivier R Busch, A Stijn L P Crobach, Otto M van Delden, Susan van Dieren, Arantza Farina and 10 more

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 17% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Observational
  2. Review
  3. Review
  4. Review
  5. Review
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

20 authors at 3 institutions in 1 country.

Nynke Michiels *Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.ORCID http://orcid.org/0000-0002-7518-4508
Deesje Doppenberg *Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Jesse V GroenDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Eran van VeldhuisenDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Bert A BonsingDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Olivier R BuschDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
A Stijn L P CrobachDepartment of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Otto M van DeldenCancer Center Amsterdam, Amsterdam, The Netherlands.
Susan van DierenDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Arantza FarinaCancer Center Amsterdam, Amsterdam, The Netherlands.
Ignace H J T de HinghDepartment of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Rob HurksCancer Center Amsterdam, Amsterdam, The Netherlands.
Joost NederendDepartment of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
Shirin Shahbazi FeshtaliDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Yeliz TankDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
A L VahrmeijerDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Martin WasserDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
J Sven D MieogDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands. j.s.d.mieog@lumc.nl.
Dutch Pancreatic Cancer Group
Leiden University Medical Center · NLAmsterdam University Medical Centers · NLRadboud University Nijmegen · NL

Funding

KWF Kankerbestrijding UL2015-7665
6 · The paper itself

Abstract

backgroundDetermining the resectability of pancreatic cancer with vascular involvement on preoperative computed tomography imaging remains challenging, especially following preoperative chemotherapy and chemoradiotherapy. Intraoperative ultrasound (IOUS) may provide real-time additional information, but prospective multicenter series confirming its value are lacking. PATIENTS AND

methodsThis prospective multicenter study included patients undergoing surgical exploration for pancreatic cancer with vascular involvement. All patients underwent IOUS at the start of explorative laparotomy. Primary outcomes were resectability status as defined by the National Comprehensive Cancer Network and the extent of vascular involvement.

resultsOverall, 85 patients were included, of whom 74 (87%) were post preoperative chemotherapy, and mostly following FOLFIRINOX regimen (n = 57; 76%). On the basis of preoperative imaging, 34 (40%) patients were staged as resectable (RPC), 32 (38%) borderline resectable (BRPC), and 19 (22%) locally advanced pancreatic cancer (LAPC). IOUS changed the resectability status in 32/85 (38%) patients (p < 0.001), including 8/19 (42%) patients with LAPC who were downstaged (4 to BRPC, 4 to RPC), and 22/32 (69%) patients with BRPC who were downstaged to RPC. Among patients with presumed superior mesenteric artery (SMA) involvement, 20/28 (71%) had no SMA involvement on IOUS. In 15 of these 20 patients a pancreatic resection was performed, all with R0 SMA margin.

conclusionIOUS during surgical exploration for pancreatic cancer and vascular involvement downstaged the resectability status in over one-third of patients, which could facilitate progress during surgical exploration. This finding should be confirmed by larger studies, including detailed pathology assessment. Trial Registration www.trialregister.nl (NL7621).

Indexed as

Pancreatic NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsHumansNeoadjuvant TherapyProspective Studies

Identifiers

PMID36774435
PMCPMC10175412
OpenAlexW4320034476

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.