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Surveillance after surgery for pancreatic cancer : a global scoping review of guidelines and a nordic Survey of contemporary practice

Ansari, Daniel LU ; Søreide, Kjetil ; Andersson, Bodil LU orcid ; Hansen, Carsten Palnæs ; Seppänen, Hanna ; Sparrelid, Ernesto ; Labori, Knut Jørgen ; Kirkegård, Jakob ; Kauhanen, Saila and Månsson, Christopher , et al. (2024) In Scandinavian Journal of Gastroenterology 59(9). p.1097-1104
Abstract

OBJECTIVES: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. ‍This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries.

MATERIALS AND METHODS: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients.

RESULTS: Altogether 16 clinical practice... (More)

OBJECTIVES: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. ‍This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries.

MATERIALS AND METHODS: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients.

RESULTS: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively.

CONCLUSION: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary.

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publication status
published
subject
keywords
Humans, Pancreatic Neoplasms/surgery, Practice Guidelines as Topic, Scandinavian and Nordic Countries, Neoplasm Recurrence, Local, Practice Patterns, Physicians'/statistics & numerical data, Surveys and Questionnaires, Pancreatectomy, Population Surveillance
in
Scandinavian Journal of Gastroenterology
volume
59
issue
9
pages
1097 - 1104
publisher
Taylor & Francis
external identifiers
  • scopus:85198340670
  • pmid:38994854
ISSN
0036-5521
DOI
10.1080/00365521.2024.2378948
language
English
LU publication?
yes
id
80d2df5c-beb2-4bb9-ab3e-72b0d494cdf7
date added to LUP
2024-09-30 13:02:02
date last changed
2025-02-04 19:26:45
@article{80d2df5c-beb2-4bb9-ab3e-72b0d494cdf7,
  abstract     = {{<p>OBJECTIVES: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. ‍This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries.</p><p>MATERIALS AND METHODS: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients.</p><p>RESULTS: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively.</p><p>CONCLUSION: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary.</p>}},
  author       = {{Ansari, Daniel and Søreide, Kjetil and Andersson, Bodil and Hansen, Carsten Palnæs and Seppänen, Hanna and Sparrelid, Ernesto and Labori, Knut Jørgen and Kirkegård, Jakob and Kauhanen, Saila and Månsson, Christopher and Nymo, Linn Såve and Nortunen, Minna and Björnsson, Bergthor and Kivivuori, Antti and Tingstedt, Bobby and Bratlie, Svein-Olav and Waardal, Kim and Laukkarinen, Johanna and Halimi, Asif and Lindberg, Hannes and Olin, Håkan and Andersson, Roland}},
  issn         = {{0036-5521}},
  keywords     = {{Humans; Pancreatic Neoplasms/surgery; Practice Guidelines as Topic; Scandinavian and Nordic Countries; Neoplasm Recurrence, Local; Practice Patterns, Physicians'/statistics & numerical data; Surveys and Questionnaires; Pancreatectomy; Population Surveillance}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1097--1104}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Surveillance after surgery for pancreatic cancer : a global scoping review of guidelines and a nordic Survey of contemporary practice}},
  url          = {{http://dx.doi.org/10.1080/00365521.2024.2378948}},
  doi          = {{10.1080/00365521.2024.2378948}},
  volume       = {{59}},
  year         = {{2024}},
}