Geographic variation in attitudes regarding management of locally advanced pancreatic cancer

Logan R. McNeil, BA; Alex B. Blair, MD; Robert W. Krell, MD; Chunmeng Zhang, MD; Aslam Ejaz, MD, MPH; Vincent P. Groot, MD, PhD; Georgios Gemenetzis, MD; James C. Padussis, MD; Massimo Falconi, MD; Christopher L. Wolfgang, MD, PhD; Matthew J. Weiss, MD; Chandrakanth Are, MD, MBA; Jin He, MD, PhD; Bradley N. Reames, MD, MS

Surgery Open Science (Oct 2022)

Geographic variation in attitudes regarding management of locally advanced pancreatic cancer

Logan R. McNeil, BA,
Alex B. Blair, MD,
Robert W. Krell, MD,
Chunmeng Zhang, MD,
Aslam Ejaz, MD, MPH,
Vincent P. Groot, MD, PhD,
Georgios Gemenetzis, MD,
James C. Padussis, MD,
Massimo Falconi, MD,
Christopher L. Wolfgang, MD, PhD,
Matthew J. Weiss, MD,
Chandrakanth Are, MD, MBA,
Jin He, MD, PhD,
Bradley N. Reames, MD, MS

Affiliations

Logan R. McNeil, BA: College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
Alex B. Blair, MD: Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
Robert W. Krell, MD: Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, TX, USA
Chunmeng Zhang, MD: Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
Aslam Ejaz, MD, MPH: Department of Surgery, Ohio State University, Columbus, OH, USA
Vincent P. Groot, MD, PhD: Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
Georgios Gemenetzis, MD: Department of Surgery, University of Glasgow School of Medicine, Glasgow, UK
James C. Padussis, MD: Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
Massimo Falconi, MD: Department of Surgery, Università Vita-Salute, San Raffaele Hospital IRCCS, Milano, Italy
Christopher L. Wolfgang, MD, PhD: Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA
Matthew J. Weiss, MD: Department of Surgery, Northwell Health, Manhasset, NY, USA
Chandrakanth Are, MD, MBA: Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
Jin He, MD, PhD: Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
Bradley N. Reames, MD, MS: Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA; Corresponding author at: Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, 986880 Nebraska Medical Center, Omaha, NE 68198. Tel.: +1 (402) 559-8941; fax:+1 (402) 559-7900.

Journal volume & issue: Vol. 10
pp. 97 – 105

Abstract

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Background: Recent literature suggests wide variations exist in the international management of locally advanced pancreatic cancer. This study sought to evaluate how geography contributes to variations in management of locally advanced pancreatic cancer. Methods: An electronic survey investigating preferences for the evaluation and management of locally advanced pancreatic cancer was distributed to an international cohort of pancreatic surgeons. Surgeons were classified according to geographic location of practice, and survey responses were compared across locations. Results: A total of 153 eligible responses were received from 4 continents: North and South America (n = 94, 61.4%), Europe (n = 25, 16.3%), and Asia (n = 34, 22.2%). Preferences for the use and duration of neoadjuvant chemotherapy and radiotherapy varied widely. For example, participants in Asia commonly preferred 2 months of neoadjuvant chemotherapy (61.8%), whereas North and South American participants preferred 4 months (52.1%), and responses in Europe were mixed (P = .006). Participants in Asia were less likely to consider isolated liver or lung metastases contraindications to exploration and consequently had a greater propensity to consider exploration in a vignette of oligometastatic disease (56.7% vs North and South America: 25.6%, Europe: 43.5%; P = .007). Conclusion: In an international survey of pancreatic surgeons, attitudes regarding locally advanced pancreatic cancer and metastatic disease management varied widely across geographic locations. Better evidence is needed to define optimal management of locally advanced pancreatic cancer.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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