Evidence map›Paper›PMID 39915735›Full record

ArticleBMC cancer2025

Study protocol of the METAPANC trial - intensified treatment in patients with local operable but oligometastatic pancreatic cancer - multimodal surgical treatment versus chemotherapy alone: a randomized controlled trial.

Michael Ghadimi, Uwe Pelzer, Marc G Besselink, Jens Siveke, Ralph Telgmann, Rickmer Braren, Hanneke Wilmink, Marie Crede, Alexander Koenig, Ute Koenig and 12 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. [Oligometastasis in the gastrointestinal tract].Chirurgie (Heidelberg, Germany) · 2026
    Article
  4. Oligometastatic disease in pancreatic cancer: is there a role for curative-intent surgery? A narrative review.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  5. Review
  6. 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

22 authors.

Michael GhadimiDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany. mghadim@gwdg.de.
Uwe PelzerDivision of Oncology and Hematology, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Marc G BesselinkDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Jens SivekeUniversity Hospital Essen, West German Cancer Center, Essen, Germany.
Ralph TelgmannClinical Trials Unit, University Medical Center Goettingen, Goettingen, Germany.
Rickmer BrarenInstitute of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany.
Hanneke WilminkDepartment of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Marie CredeDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Alexander KoenigDepartment of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, Goettingen, Germany.
Ute KoenigDepartment of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, Goettingen, Germany.
Sven Thorsten LiffersUniversity Hospital Essen, West German Cancer Center, Essen, Germany.
Kai AntweilerDepartment of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
Bas UijterwijkDepartment of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Hanna SeppanenDepartment of Gastrointestinal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Arno NordinDepartment of Gastrointestinal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Pauli PuolakkainenDepartment of Abdominal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Olav F DajaniDepartment of Oncology, Oslo University Hospital, Oslo, Norway.
Knut Jørgen LaboriDepartment of Hepato Pancreato Biliary Surgery, Oslo University Hospital, Oslo, Norway.
Mia JohanssonDepartment of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Svein Olav BratlieDepartment of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Tim FriedeDepartment of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
Peter JoDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBased on current guidelines, surgical treatment of hepatic oligometastases in patients with pancreatic ductal adenocarcinoma (PDAC) is not primarily recommended. Systematic chemotherapy is the therapy of choice for these patients. The relevance of subsequent surgical resection after chemotherapy remains unclear. This multicentre, randomized, controlled phase III trial is planned to evaluate whether resection of the primary tumor and liver metastases can improve overall survival in patients with PDAC with hepatic oligometastases in a multimodal treatment setting.

methodsAfter an induction therapy with eight cyles of mFOLFIRINOX and a response assessment after four and eight cycles, patients will be randomized to either Arm 1 (perioperative mFOFIRINOX plus resection of the primary tumor with resection or ablation of all hepatic metastases) or Arm 2 (continuation of 4 cycles of the standard-of-care mFOLFIRINOX chemotherapy). This clinical trial will focus on a well-defined patient group with metastatic disease limited to the liver as the target organ, with a maximum of three metastases. DISCUSSION: METAPANC is the first international, randomized, controlled, open-label, multicentre, phase III clinical trial for curative intended surgical therapy of oligometastatic pancreatic cancer in Europe and America. The multimodal surgical treatment of patients with oligometastatic pancreatic cancer could significantly extend the overall survival of this patient group. A possible recommendation of this multimodal treatment regimen outside of clinical trials requires data from randomized controlled trials first. To identify patient subgroups that might benefit from multimodal surgical therapy, additional information on tumor genetics could supplement valid parameters.

trial registrationEU Clinical Trials No. 2023-503558-10-00.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Pancreatic DuctalLiver NeoplasmsPancreatic NeoplasmsClinical Trials, Phase III as TopicCombined Modality TherapyFemaleFluorouracilHumansIrinotecanLeucovorinMaleMulticenter Studies as TopicOxaliplatinPancreatectomyRandomized Controlled Trials as TopicFluorouracilfolfirinoxIrinotecanLeucovorinOxaliplatinChemotherapyClinical trialsLiver metastasisMultimodal treatmentOligometastasisOligometastatic pancreatic cancerPancreatic ductal carcinoma (PDAC)Pancreatic surgery

Identifiers

PMID39915735
PMCPMC11800597

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Registered trials

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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.