Intra-observer agreements in multidisciplinary team assessments of pancreatic cancer patients

J. Kirkegard*, M. Al-Saiddi, S.O. Bratlie, M. Coolsen, R.J. de Haas, M. den Dulk, C. Fristrup, O.J. Greve, E. Harrison, G. Koutouzi, R.L. Miclea, M.B. Mortensen, M.W. Nijkamp, J. Persson, F.P. Robertson, J.J.G. Slangen, J.A. Soreide, S.J. Wigmore, F.V. Mortensen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and Methods Treatment strategies for pancreatic cancer patients are made by a multidisciplinary team (MDT) board. We aimed to assess intra-observer variance at MDT boards. Participating units staged, assessed resectability, and made treatment allocations for the same patients as they did two years earlier. We disseminated clinical information and CT images of pancreatic cancer patients judged by one MDT board to have nonmetastatic pancreatic cancer to the participating units. All units were asked to re-assess the TNM stage, resectability, and treatment allocation for each patient. To assess intra-observer variance, we computed %-agreements for each participating unit, defined as low (<50%), moderate (50%-75%), and high (>75%) agreement. Results Eighteen patients were re-assessed by six MDT boards. The overall agreement was moderate for TNM-stage (ranging from 50%-70%) and resectability assessment (53%) but low for treatment allocation (46%). Agreement on resectability assessments was low to moderate. Findings were similar but more pronounced for treatment allocation. We observed a shift in treatment strategy towards increasing use of neoadjuvant chemotherapy, particularly in patients with borderline resectable and locally advanced tumors. Conclusions We found substantial intra-observer agreement variations across six different MDT boards of 18 pancreatic cancer patients with two years between the first and second assessment.
Original languageEnglish
Pages (from-to)1402-1408
Number of pages7
JournalJournal of Surgical Oncology
Issue number8
Early online date7 Sept 2021
Publication statusPublished - Dec 2021


  • neoadjuvant chemotherapy
  • pancreatic cancer
  • resectability
  • treatment allocation
  • variation

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