ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2021
Resectability of Pancreatic Cancer Is in the Eye of the Observer: A Multicenter, Blinded, Prospective Assessment of Interobserver Agreement on NCCN Resectability Status Criteria.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03673423 (Interobserver Variability In The Assessment Of Vascular Invasion In Pancreatic Cancer), which is not on this map. Cited by 21 papers.
What it found
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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.
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.
Interobserver Variability In The Assessment Of Vascular Invasion In Pancreatic Cancer
Who cites it
21 citing papers in PubMed, 28 citations in OpenAlex.
- Quantitative and qualitative evaluation of pancreatic cancer on photon-counting detector CT and dual-energy CT using standard reference images.Abdominal radiology (New York) · 2026Article
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- CT-based vascular invasion in pancreatic ductal adenocarcinoma compared with intraoperative and histological findings.Insights into imaging · 2026Article
- A clinician-centric intelligent method towards reliable pancreatic cancer vascular invasion assessment: a retrospective, multi-centre study.The Lancet regional health. Western Pacific · 2026Article
- Prognostic impact of pathologically confirmed venous infiltration during upfront pancreatectomy: multicenter survival analysis.Langenbeck's archives of surgery · 2026Article
- Virtual reality volumetric rendering versus cross-sectional imaging for pancreatic cancer resectability assessment: a pilot randomized controlled reader study.Bioelectronic medicine · 2026Article
- New implications from long-term outcomes of perioperative therapy in resectable pancreatic cancer.British journal of cancer · 2026Review
- UBE2W promotes pancreatic cancer progression through regulating K63-linked ubiquitination of p53.American journal of cancer research · 2026Article
- Diagnosis and Surgical Management for Advanced Pancreatic Cancer Requiring Vascular Resection.Diagnostics (Basel, Switzerland) · 2025Review
- The British technique of purely robotic Whipple's pancreatoduodenectomy a systematic and stepwise ('clockwise') approach.Hepatobiliary surgery and nutrition · 2025Article
- Real-World Evidence of Porto-Mesenteric Vein Resections with Pancreatectomy and the Development of Predictive Clinical Nomograms for Postoperative Outcomes-An Analysis of 389 Cases: The "Porto-Mesenteric Vein Resection-Indian MulticentrE" (PRIME) Study.Annals of surgical oncology · 2025Observational
- ASO Author Reflections: Predictive Clinical Nomograms for Postoperative Outcomes Following Porto-Mesenteric Vein Resection with Pancreatectomy: Identifying the Best Patient for a High-Acuity Surgery.Annals of surgical oncology · 2025Article
- Review
- An overview of the feasibility of nanomedicine in pancreatic cancer theranostics.Exploration of targeted anti-tumor therapy · 2025Review
- Article
- A clinical-radiomics nomogram based on dual-layer spectral detector CT to predict cancer stage in pancreatic ductal adenocarcinoma.Cancer imaging : the official publication of the International Cancer Imaging Society · 2024Article
- Artificial intelligence for assessment of vascular involvement and tumor resectability on CT in patients with pancreatic cancer.European radiology experimental · 2024Article
- Preoperative chemotherapy, radiotherapy and surgical decision-making in patients with borderline resectable and locally advanced pancreatic cancer.Nature reviews. Gastroenterology & hepatology · 2024Review
- Computer-Aided Detection for Pancreatic Cancer Diagnosis: Radiological Challenges and Future Directions.Journal of clinical medicine · 2023Review
- Intraoperative Ultrasound During Surgical Exploration in Patients with Pancreatic Cancer and Vascular Involvement (ULTRAPANC): A Prospective Multicenter Study.Annals of surgical oncology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 14 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: To determine the reproducibility of the National Comprehensive Cancer Network (NCCN) resectability status classification for pancreatic cancer. Background: The NCCN classification defines 3 resectability classes (resectable, borderline resectable, locally advanced), according to vascular invasion. It is used to recommend different approaches and stratify patients during clinical trials. Methods: Prospective, multicenter, observational study (trial ID: NCT03673423). Main outcome measure was the interobserver agreement of tumor assignment to different resectability classes and quantification of vascular invasion degrees. Agreement was measured by Fleiss' k (k = 1 perfect agreement; k = 0 agreement by chance). Sixty-nine computed tomography (CT) scans of pathologically confirmed pancreatic adenocarcinoma were independently reviewed in a blinded fashion by 22 observers from 11 hospitals (11 surgeons and 11 radiologists). Rating differences between surgeons or radiologists and between hospitals with different volumes (≥60 or <60 resections/year) were assessed. Results: Complete agreement among 22 observers was recorded in 5 CT scans (7.2%), whereas 25 CT scans (36.2%) were variously assigned to all 3 resectability classes. Interobserver agreement varied from fair to moderate (Fleiss' k range: 0.282-0.555), with the lowest agreement for borderline resectable tumors. Assessing vascular contact ≤180° had the lowest agreement for all vessels (k range: 0.196-0.362). The highest concordance was recorded for venous invasion >180° (k range: 0.619-0.756). Neither reviewers' specialty nor hospital volume influenced the agreement. Conclusions: There is high variability in the assignment to resectability categories, which may compromise the reliability of treatments recommendations and the evidence of trials stratifying patients in resectability classes. Criteria should be revised to allow a reproducible classification.
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Registered trials
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.