Time from imaging to surgery and risk of non-resectability in pancreatic cancer patients

Aim

The aim of this project is to investigate the association between time from preoperative imaging to surgery and the risk of non-resectability in pancreatic cancer patients.

Study design

This is a cohort-study.

The primary data source will be the Danish Pancreatic Cancer Database which is a clinical quality database with information on all pancreatic cancer diagnoses since 2011 and has nearly 100% coverage. The registry is fully automated and is cross-linked with the Danish National Patient Registry and the Danish Register of Pathology to ensure completeness and validity.

The study population will be all patients recorded in the Danish Pancreatic Cancer Database with a surgical procedure (resection or exploration) during 2015-2024 (n~2,500). The exposure is time from most recent CT of the abdomen until surgery. The measured outcome the risk of non-resectability (tumor growth or metastatic disease), expectedly 20% of the population (n~500).

About the project

Pancreatic cancer is an aggressive malignancy with a 5-year-survival less than 10%.

Patients often present with little or no symptoms, which contributes to late diagnosis and a reduced possibility for curative-intent surgery. Surgical resectability is estimated based on several diagnostic images and each patient is carefully evaluated at multidisciplinary team conferences.

Despite through assessment, 20-25% of patients will be deemed non-resectable during surgery. The surgical opening of the abdomen, the laparotomy, is considered futile and is associated with a very poor prognosis, both due to likely postoperative complications and rapid clinical deterioration. Thus, it is crucial to reduce the number of futile laparotomies.

We hypothesise that non-resectability increases with increasing time from imaging to surgery and wish to clarify this relationship.

The project at ClinicalTrials.gov