Evidence map›Paper›PMID 39972248›Full record

ArticleBMC cancer2025

Nationwide implementation of the international multidisciplinary best-practice for locally advanced pancreatic cancer (PREOPANC-4): study protocol.

T F Stoop, L W F Seelen, F R van 't Land, A C van der Hout, J C M Scheepens, M Ali, A M Stiggelbout, B M van der Kolk, B A Bonsing, D J Lips and 48 more

2 registry-linked trialsAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
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. It is linked to 2 registered trials, which are not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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.

NCT03513705 nacompletednot on this map

Impact of Nationwide Enhanced Implementation of Best Practices in Pancreatic Cancer Care (PACAP-1): a Multicenter Stepped-wedge Cluster Randomized Controlled Trial

TypeinterventionalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2018 to 2021Enrolled4,000ConditionsCarcinoma, Pancreatic DuctalArmsBest practices in pancreatic cancer care
NCT05524090 recruitingnot on this map

Nationwide Implementation Program for Optimal Multidisciplinary Management and Resection of Locally Advanced Pancreatic Cancer (PREOPANC-4)

Typeobservational_patient_registrySponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2021 to 2030Enrolled223ConditionsPancreatic Cancer, Locally Advanced Pancreatic Adenocarcinoma, Pancreatic Adenocarcinoma Non-resectable, Chemotherapy EffectArmsImplementation - International best-practice care
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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

58 authors.

T F Stoop *Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
L W F Seelen *Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht / St. Antonius Hospital Nieuwegein, Nieuwegein & Utrecht, the Netherlands.
F R van 't Land *Department of Surgery and Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
A C van der HoutDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
J C M ScheepensDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht / St. Antonius Hospital Nieuwegein, Nieuwegein & Utrecht, the Netherlands.
M AliCancer Center Amsterdam, Amsterdam, the Netherlands.
A M StiggelboutDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
B M van der KolkDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
B A BonsingDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
D J LipsDepartment of Surgery, Medisch Spectrum Twente, Enschede, the Netherlands.
D J A de GrootDepartment of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
E van VeldhuisenAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
E D KerverDepartment of Medical Oncology, OLVG, Amsterdam, the Netherlands.
E R ManusamaDepartment of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
F DaamsCancer Center Amsterdam, Amsterdam, the Netherlands.
G KazemierCancer Center Amsterdam, Amsterdam, the Netherlands.
G A CirkelDepartment of Medical Oncology, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center Utrecht, Nieuwegein & Utrecht, the Netherlands.
G van TienhovenAmsterdam UMC, Location University of Amsterdam, Department of Radiation Oncology, Amsterdam, the Netherlands.
G A PatijnDepartment of Surgery, Isala, Zwolle, the Netherlands.
H N Lelieveld-RierDepartment of Medical Oncology, Amphia Hospital, Breda, the Netherlands.
I H de HinghDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
I E G van HellemondDepartment of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
J H WijsmanDepartment of Surgery, Amphia Hospital, Breda, the Netherlands.
J I ErdmannAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
J S D MieogDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
J de Vos-GeelenDepartment of Internal Medicine, Division of Medical Oncology, GROW - Research Institute for Oncology & Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands.
J W B de GrootDepartment of Medical Oncology, Isala Oncology Center, Isala, Zwolle, the Netherlands.
K R D LutchmanAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
L J MekenkampDepartment of Medical Oncology, Medisch Spectrum Twente, Enschede, the Netherlands.
L W KranenburgDepartment of Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.
L P M BeukDepartment of Surgery and Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
M W NijkampDepartment of Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
M den DulkDepartment of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
M B PoléeDepartment of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
M Y V HomsDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
M L WumkesDepartment of Medical Oncology, Jeroen Bosch Hospital, 's , Hertogenbosch, the Netherlands.
M W J StommelDepartment of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
O R BuschAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
R F de WildeDepartment of Surgery and Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
R T TheijseAmsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands.
S A C LuelmoDepartment of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands.
S FestenDepartment of Surgery, OLVG, Amsterdam, the Netherlands.
T L BollenDepartment of Radiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
U P NeumannDepartment of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
V E de MeijerDepartment of Surgery, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
W A DraaismaDepartment of Surgery, Jeroen Bosch Hospital, 's, Hertogenbosch, the Netherlands.
B Groot KoerkampDepartment of Surgery and Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
I Q MolenaarDepartment of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht / St. Antonius Hospital Nieuwegein, Nieuwegein & Utrecht, the Netherlands.
C L WolfgangDepartment of Surgery, NYU Langone Health, New York, NY, USA.
M Del ChiaroDivision of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
M G H KatzDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
T HackertDepartment of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
J A C Rietjens *Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
J W Wilmink *Cancer Center Amsterdam, Amsterdam, the Netherlands.
H C van Santvoort *Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht / St. Antonius Hospital Nieuwegein, Nieuwegein & Utrecht, the Netherlands.
C H J van Eijck *Department of Surgery and Pulmonology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, the Netherlands.
M G Besselink *Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands. m.g.besselink@amsterdamUMC.nl.
Dutch Pancreatic Cancer Group

Funding

Deltaplan Alvleesklierkanker/Maag-Lever-Darm Stichting #2022-003 / WOO 21-02KWF Kankerbestrijding #2021-2 / 14106
6 · The paper itself

Abstract

backgroundThe introduction of (m)FOLFIRINOX and gemcitabine-nab-paclitaxel has changed the perspective for patients with locally advanced pancreatic cancer (LAPC). Consequently, in experienced centres 23% of patients with LAPC undergo a resection with 5-year overall survival (OS) rates of up to 25%. In the Netherlands, the nationwide resection rate for LAPC remains low at 8%. The PREOPANC-4 program aims for a nationwide implementation of the international multidisciplinary best-practice to improve patient outcome.

methodsNationwide program implementing the international multidisciplinary best-practice for LAPC. In the training phase, multidisciplinary and surgical webinars are given by 4 international experts, leading to a clinical protocol, followed by surgical off-site and on-site proctoring sessions. In the implementation phase, the clinical protocol will be implemented in all centres, including a nationwide expert panel (2022-2024). Healthcare professionals will be trained in shared decision-making. Consecutive patients diagnosed with pathology-proven LAPC (i.e., arterial involvement > 90° and/or portomesenteric venous > 270° involvement or occlusion [DPCG criteria]) are eligible. Primary outcomes are median and 5-year OS from diagnosis, resection rate, in-hospital/30-day mortality and major morbidity (i.e., Clavien-Dindo grade ≥ IIIa), and radical resection (R0) rate. Secondary outcomes include quality of life, functioning, side effects, and patients' healthcare satisfaction in all included patients. Outcomes will be compared with patients with borderline resectable pancreatic cancer (BRPC) treated with neoadjuvant FOLFIRINOX in the PREOPANC-2 trial (EudraCT: 2017-002036-17) and a historical cohort of patients with LAPC from the PACAP registry (NCT03513705). The existing prospective LAPC Registry and PACAP PROMs (NCT03513705) will be used for data collection. In qualitative interviews, treatment preferences, values, and experiences of LAPC patients, their relatives, and healthcare professionals will be assessed for the development of shared decision-making supportive tools. It is hypothesized that the program will double the nationwide LAPC resection rate to 16% with major morbidity < 50% and mortality ≤ 5%, and OS following resection similar to that observed in patients with BRPC. DISCUSSION: The PREOPANC-4 program aims to safely implement the international multidisciplinary best-practice for LAPC leading to benchmark outcomes for both short-term morbidity, mortality, and OS.

trial registrationPREOPANC-4 program was registered at ClinicalTrials.gov (NCT05524090) on September 1, 2022.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsPancreatic NeoplasmsAlbuminsDeoxycytidineFluorouracilGemcitabineHumansIrinotecanLeucovorinNetherlandsOxaliplatinPaclitaxelPancreatectomyQuality of Life130-nm albumin-bound paclitaxelAlbuminsDeoxycytidineFluorouracilfolfirinoxGemcitabineIrinotecanLeucovorinOxaliplatinPaclitaxelImplementation programInduction therapyLocally advanced pancreatic cancerSurgeryThe Netherlands

Identifiers

PMID39972248
PMCPMC11841322

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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.