ࡱ > $ ( ! " # q L bjbjll 7 efef 8 8 K ! ) ) ) ) * - . I I I I I I I $ IM O X J M/ * * M/ M/ J ) ) /K 0 ; ; ; M/ ) ) A R ; M/ I ; ; = <> ) l0a #6 F > A _K < K > , WP i6 WP <> <> & WP b> $ M/ M/ ; M/ M/ M/ M/ M/ J J 9 M/ M/ M/ K M/ M/ M/ M/ WP M/ M/ M/ M/ M/ M/ M/ M/ M/ 8 X : Supplementary Online Materials
TOC \o "1-2" \h \z \u HYPERLINK \l "_Toc20478381" Table S1. Database search queries PAGEREF _Toc20478381 \h 2
HYPERLINK \l "_Toc20478382" Table S2. Study populations PAGEREF _Toc20478382 \h 3
HYPERLINK \l "_Toc20478383" Table S3. Key characteristics of the included studies PAGEREF _Toc20478383 \h 9
HYPERLINK \l "_Toc20478384" Table S4. Narrative summary of study findings PAGEREF _Toc20478384 \h 12
HYPERLINK \l "_Toc20478385" Studies measuring delay from symptom onset PAGEREF _Toc20478385 \h 12
HYPERLINK \l "_Toc20478386" Studies measuring delay from first specialist consultation PAGEREF _Toc20478386 \h 13
HYPERLINK \l "_Toc20478387" Studies measuring delay from first cross-sectional imaging PAGEREF _Toc20478387 \h 14
HYPERLINK \l "_Toc20478388" Studies measuring delay from cancer diagnosis PAGEREF _Toc20478388 \h 16
HYPERLINK \l "_Toc20478389" Table S5. Bias assessment in cohort studies (MINORS score) PAGEREF _Toc20478389 \h 17
HYPERLINK \l "_Toc20478390" Table S6. PRISMA checklist PAGEREF _Toc20478390 \h 18
HYPERLINK \l "_Toc20478391" References to Supplementary Information PAGEREF _Toc20478391 \h 19
Table S1. Database search queries
PubMed query: search on 20th October 2017, 823 hits
((("pancreas"[MeSH Terms] OR "pancreas"[All Fields] OR "pancreatic"[All Fields]) OR ("pancreas"[MeSH Terms] OR "pancreas"[All Fields])) AND (("neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "cancer"[All Fields]) OR ("tumour"[All Fields] OR "neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "tumor"[All Fields]) OR ("tumour"[All Fields] OR "neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "tumor"[All Fields]) OR malign[All Fields]) AND (delay[All Fields] OR "time lag"[All Fields] OR "timelag"[All Fields] OR "late"[All Fields]) AND (("diagnosis"[Subheading] OR "diagnosis"[All Fields] OR "diagnosis"[MeSH Terms]) OR ("therapy"[Subheading] OR "therapy"[All Fields] OR "treatment"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields])) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms]) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms] AND (("2000/01/01"[PDAT] : "2017/12/31"[PDAT]) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms])
Update search on 3rd August 2018 for records created, completed, or modified in the 20 October 31 December 2017 period: 93 records, by title/abstract scrolling none of them was relevant.
(((("pancreas"[MeSH Terms] OR "pancreas"[All Fields] OR "pancreatic"[All Fields]) OR ("pancreas"[MeSH Terms] OR "pancreas"[All Fields])) AND (("neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "cancer"[All Fields]) OR ("tumour"[All Fields] OR "neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "tumor"[All Fields]) OR ("tumour"[All Fields] OR "neoplasms"[MeSH Terms] OR "neoplasms"[All Fields] OR "tumor"[All Fields]) OR malign[All Fields]) AND (delay[All Fields] OR "time lag"[All Fields] OR "timelag"[All Fields] OR "late"[All Fields]) AND (("diagnosis"[Subheading] OR "diagnosis"[All Fields] OR "diagnosis"[MeSH Terms]) OR ("therapy"[Subheading] OR "therapy"[All Fields] OR "treatment"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields])) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms]) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms] AND (("2000/01/01"[PDAT] : "2017/12/31"[PDAT]) AND "humans"[MeSH Terms] AND "adult"[MeSH Terms])) AND ((("2017/10/20"[CRDAT] : "2017/12/31"[CRDAT]) OR ("2017/10/20"[CDAT] : "2017/12/31"[CDAT])) OR ("2017/10/20"[MDAT] : "2017/12/31"[MDAT]))Scopus query: search on 18th April 2018, 3603 hits
( ( TITLE-ABS-KEY ( "pancreas" ) OR TITLE-ABS-KEY ( "pancreatic" ) ) ) AND ( ( TITLE-ABS-KEY ( "neoplasm" ) OR TITLE-ABS-KEY ( "cancer" ) OR TITLE-ABS-KEY ( "tumour" ) OR TITLE-ABS-KEY ( "tumor" ) OR TITLE-ABS-KEY ( "malign" ) ) ) AND ( ( TITLE-ABS-KEY ( "delay" ) OR TITLE-ABS-KEY ( "time lag" ) OR TITLE-ABS-KEY ( "timelag" ) OR TITLE-ABS-KEY ( "late" ) ) ) AND ( ( TITLE-ABS-KEY ( "diagnosis" ) OR TITLE-ABS-KEY ( "therapy" ) OR TITLE-ABS-KEY ( "treatment" ) OR TITLE-ABS-KEY ( "therapeutics" ) ) ) AND ( LIMIT-TO ( PUBYEAR , 2017 ) OR LIMIT-TO ( PUBYEAR , 2016 ) OR LIMIT-TO ( PUBYEAR , 2015 ) OR LIMIT-TO ( PUBYEAR , 2014 ) OR LIMIT-TO ( PUBYEAR , 2013 ) OR LIMIT-TO ( PUBYEAR , 2012 ) OR LIMIT-TO ( PUBYEAR , 2011 ) OR LIMIT-TO ( PUBYEAR , 2010 ) OR LIMIT-TO ( PUBYEAR , 2009 ) OR LIMIT-TO ( PUBYEAR , 2008 ) OR LIMIT-TO ( PUBYEAR , 2007 ) OR LIMIT-TO ( PUBYEAR , 2006 ) OR LIMIT-TO ( PUBYEAR , 2005 ) OR LIMIT-TO ( PUBYEAR , 2004 ) OR LIMIT-TO ( PUBYEAR , 2003 ) OR LIMIT-TO ( PUBYEAR , 2002 ) OR LIMIT-TO ( PUBYEAR , 2001 ) OR LIMIT-TO ( PUBYEAR , 2000 ) )Cochrane Database of Systematic Reviews query: search on 17th April 2018, 117 hits
'"pancreas" OR pancreatic in Title, Abstract, Keywords in Cochrane Reviews'Library, Information Science & Technology Abstracts database (EBSCO) search via embedded EndNote feature, 12th Sep 2019, 267 hits
Any field contains pancreas OR any field contains pancreatic AND any field contains cancerLibrary of Congress search via embedded EndNote feature, 12th Sep 2019, 22 hits; limited to years 2000-2019: 20 hits
Any field contains pancreas OR any field contains pancreatic AND any field contains cancerTable S2. Study populations
Ref.Arm/cohort IDNAge% maleCancer typeStageGradeOtherHealy et al. HYPERLINK \l "_ENREF_1" \o "Healy, 2018 #2474" ADDIN EN.CITE ADDIN EN.CITE.DATA 1Full cohort239Resected (N=210): mean 65.5, SD 9.4;
Unexpected progression (N=29): mean 61.6, SD 10.7Resected: 61%; Unexpected progression: 72%all patients undergoing curative intent surgical exploration for pancreatic or periampullary adenocarcinoma. Periampullary cancers with intestinal histology were excluded.The NCCN definition of resectability was used, which states that there can be no distant metastasis (including non-regional lymph nodes), no arterial tumor contact (coeliac artery, superior mesenteric arte r y , c o m m o n h e p a t i c a r t e r y ) , n o t u m o r c o n t a c t w i t h t h e s u p e r i o r m e s e n t e r i c v e i n o r p o r t a l v e i n , o r d"1 8 0 d e g r e e v e i n c o n t a c t w i t h o u t v e i n c o n t o u r i r r e g u l a r i t y . B o r d e r l i n e r e s e c t a b l e d i s e a s e ( d e f i n e d b y t h e N a t i o n a l C o m p r e h e n s i v e C a n c e r N e t w o r k ( N C C N ) g u i d e lines) was also exclusion criteria.n.a.Those who received neoadjuvant chemotherapy, and patients without preoperative contrastenhanced abdominal CT were excluded. Marchegiani et al. HYPERLINK \l "_ENREF_2" \o "Marchegiani, 2017 #2479" ADDIN EN.CITE Marchegiani201724792479247917Marchegiani, G.Andrianello, S.Perri, G.Secchettin, E.Maggino, L.Malleo, G.Bassi, C.Salvia, R.Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, ItalyDoes the surgical waiting list affect pathological and survival outcome in resectable pancreatic ductal adenocarcinoma?HPBHPBhttps://doi.org/10.1016/j.hpb.2017.10.0172017Article in Presshttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85035203960&doi=10.1016%2fj.hpb.2017.10.017&partnerID=40&md5=983ca9b5649b7d2cdd196fed9d6066f9scopus_S1_ 1.6 Original study10.1016/j.hpb.2017.10.017Scopus2Full cohort217Median 66, range 37-8547.5%PDACResectable (R0-R2) cases only.
T1 4.1%
T2 2.3%
T3 92.2%
T4 1.4%
N1 85.3%
Lymphovascular involvement 95.4%
Perineural invasion 96.8%G1 6.1%; G2 66.2%;
G3 27.8%Excluding patients treated
with neoadjuvant chemotherapy or radiotherapy, and with incomplete data. Macroscopically incomplete resections were excluded from all survival analyses. Jooste et al. HYPERLINK \l "_ENREF_3" \o "Jooste, 2016 #1674" ADDIN EN.CITE ADDIN EN.CITE.DATA 3Full cohort45031.6% <65
36.4% 65-79
32.0% >7948%Pancreatic cancer (ICD C25)M1: 54%n.a.n.a.Amr et al. HYPERLINK \l "_ENREF_4" \o "Amr, 2016 #1678" ADDIN EN.CITE ADDIN EN.CITE.DATA 4Periampullary, cancer, full cohort266Median 67, range 41-86 57%Periampullary cancer of pancreatic origin (N=149),
of bile duct origin (N=46), or
ampullary cancer (N=71)100% completed resection surgery.
n.a.n.a.Periampullary, pancreatic origin subgroup149Median 68, range 41-8255%Periampullary cancer of pancreatic originResection surgery,
N+ 85.2%, resection margin involved 79.9%Sanjeevi et al.
HYPERLINK \l "_ENREF_5" \o "Sanjeevi, 2016 #1702" ADDIN EN.CITE ADDIN EN.CITE.DATA 5Full cohort349Median 68, range 42-8656%PDAC, histologically confirmedSurgical candidates only, deemed resectableI 55.3%;
II 26.1%;
IIIa 7.7%;
IIIb 7.4%;
IVa 1.1%;
IVb 0.3%Those who had completed neoadjuvant treatment for initially unresectable or borderline tumors had to have stable disease or remissionSwords et al. HYPERLINK \l "_ENREF_6" \o "Swords, 2015 #1716" ADDIN EN.CITE ADDIN EN.CITE.DATA 6Proper initial diagnosis 215Mean 68.0, SD 10.1 years53%PDAC in proximal pancreasI 6.1%, II 50.2%, III 20%, IV 23.7%n.a.Race: white 84.7%, other / missing 15.3%Initially misdiagnosed98Mean 62.8, SD 12.657%I 5.1%, II 33.7%, III 21.4%, IV 39.8%Driedger et al. HYPERLINK \l "_ENREF_7" \o "Driedger, 2015 #1737" ADDIN EN.CITE ADDIN EN.CITE.DATA 7Full cohort133Mean 63, range 36-8642%Solid pancreatic lesion concerning for a pancreatic adenocarcinoma on diagnostic imagingn.a.n.a.n.a.Raman et al. HYPERLINK \l "_ENREF_8" \o "Raman, 2015 #2473" ADDIN EN.CITE ADDIN EN.CITE.DATA 8Full cohort256Median 67, range 30-9552%Pathologically proven pancreatic adenocarcinoman.a.n.a.Patients who had undergone surgery with the intent to perform curative resection, surgical palliation, or diagnostic exploration, and a previous multidetector CT scan.Gobbi et al. HYPERLINK \l "_ENREF_9" \o "Gobbi, 2013 #1879" ADDIN EN.CITE ADDIN EN.CITE.DATA 9Full cohort170Mean 65.8, SD 10.2, range 36-9159%Newly diagnosed pancreatic cancer. Neuroendocrine, ampullary or duodenal tumors were excluded.I 3.5%, II 21.8%, III 16.5%, IV 58.2%n.a.Chemotherapy was a stratifying factorMcLean et al. HYPERLINK \l "_ENREF_10" \o "McLean, 2013 #2464" ADDIN EN.CITE ADDIN EN.CITE.DATA 10Periampullary adenocarcinoma subgroup119n.a.n.a.Periampullary cancer of pancreatic origin (N=83), of bile duct origin (N=15), ampullary cancer (N=16), or duodenum (N=5)100% completed resection surgeryn.a.n.a.Deriban et al. HYPERLINK \l "_ENREF_11" \o "Deriban, 2012 #1876" ADDIN EN.CITE Deriban201218761876187617Deriban, G.Andreevski, B.Mishevski, J.Krstevski, M.Trajkovska, M.Popova, R.Joksimovic, N.Serafimoski, V.University Gastroenterohepatology Clinic, Medical Faculty, Skopje, R. Macedonia.Obstructive jaundice caused by pancreatic head malignancies are there predictive factors for successful endoscopic biliary stenting?PriloziPriloziPriloziPriloziPriloziPrilozi59-713322013/02/22AdultAgedAged, 80 and over*Cholangiopancreatography, Endoscopic RetrogradeFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complicationsProspective Studies*StentsTreatment Outcome20120351-3254 (Print)
0351-3254234258701.3 Not relevant topic1.6 Original studyScreening S1.6NLMeng11Full cohort50Median 66, range 38-8944%Pancreatic head malignancyn.a.n.a.n.a.Yun et al. HYPERLINK \l "_ENREF_12" \o "Yun, 2012 #1924" ADDIN EN.CITE ADDIN EN.CITE.DATA 12Full cohort2309Minimum 20n.a.Pancreatic cancer (ICD C25) patients undergoing any type of surgeryn.a.n.a.n.a.Glant et al. HYPERLINK \l "_ENREF_13" \o "Glant, 2011 #2467" ADDIN EN.CITE ADDIN EN.CITE.DATA 13Full cohort487n.a.n.a.PDAC or invasive intraductal papillary mucinous neoplasm confirmed by final pathology or intraoperative biopsy. Tumors in pancreatic head, proximal neck, or uncinate process were termed proximal PDAC and those of the body and tail as distal PDAC. Tumors involving both the proximal and distal pancreas were considered in the proximal PDAC group.Patients with suspected metastases based on preoperative imaging were removed from further analysis.n.a.Patients receiving neoadjuvant chemotherapy or radiation therapy or who had previously undergone operation including an attempted or successful resection and exploratory laparoscopy were not included.Eshuis et al. HYPERLINK \l "_ENREF_14" \o "Eshuis, 2010 #2007" ADDIN EN.CITE ADDIN EN.CITE.DATA 14Early surgery arm90Mean 64.6, SD 9.570%Obstructive jaundice due to a suspected periampullary malignancy. Histology: pancreatic adenocc 57%, ampullary adenocc 23%, common bile duct adenocc 11%, duodenal adenocc 2%, neuroendocrine 1%, cystic tumour 6%No evidence of locoregional irresectable or metastatic disease on computed tomography in last 4 days before random i z a t i o n n . a . S e r u m t o t a l b i l i r u b i n l e v e l o f 4 0 t o 2 5 0 m o l / L ( 2 . 3 1 4 . 6 m g / d L ) P r e o p e r a t i v e b i l i a r y d r a i n a g e a r m 9 5 M e a n 6 4 . 7 , S D 1 0 . 3 5 4 % R a p t i s e t a l . H Y P E R L I N K \ l " _ E N R E F _ 1 5 " \ o " R a p t i s , 2 0 1 0 # 2 0 2 1 " A D D I N E N . C I T E A D D I N E N . C I T E . D A T A 1 5 Full cohort355Median 64, IQR 56-71n.a.PDACInoperable 71%, resectable 10%, bypass surgery 19%n.a.n.a.Tokuda et al. HYPERLINK \l "_ENREF_16" \o "Tokuda, 2009 #2477" ADDIN EN.CITE Tokuda200924772477247717Tokuda, Y.Chinen, K.Obara, H.Joishy, S. K.Center for Clinical Epidemiology, St Luke's Life Science Institute, Tokyo. tokuyasu@orange.ocn.ne.jpIntervals between symptom onset and clinical presentation in cancer patientsIntern MedInternal medicine (Tokyo, Japan)Intern MedInternal medicine (Tokyo, Japan)Intern MedInternal medicine (Tokyo, Japan)899-90548112009/06/02AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasm Metastasis/diagnosis/therapyNeoplasms/ diagnosis/ therapyRegistriesRetrospective StudiesTime FactorsYoung Adult20091349-7235 (Electronic)
0918-2918 (Linking)19483358Screening C1.6NLMeng16Pancreas cancer subgroup57n.a.n.a.Pancreas cancerDistant metastases in 57.9% (33/57) at first diagnostic workupn.a.Excluded patients who had developed no prior symptoms (incidentally identified cases) and asymptomatic patients who had been referred from cancer screening programs from the study.Ghadimi et al. HYPERLINK \l "_ENREF_17" \o "Ghadimi, 2002 #2347" ADDIN EN.CITE Ghadimi200223472347234717Ghadimi, B. M.Horstmann, O.Jacobsen, K.Feth, J.Becker, H.Dept. of Surgery, University Medical Center Gottingen, Georg-August-University Gottingen, Germany.Delay of diagnosis in pancreatic cancer due to suspected symptomatic cholelithiasisScand J GastroenterolScandinavian journal of gastroenterologyScand J GastroenterolScandinavian journal of gastroenterologyScand J GastroenterolScandinavian journal of gastroenterology1437-937122003/01/14Adenocarcinoma/*diagnosis*Ampulla of VaterCholecystectomy/statistics & numerical dataCholelithiasis/*complicationsCommon Bile Duct Neoplasms/*complicationsHumansMiddle AgedPancreatic Neoplasms/*diagnosisTime FactorsWeight Loss2002Dec0036-5521 (Print)
0036-5521125235941.6 Original study1.6 Original studyScreening C1.6NLMeng17Full cohort186Mean 63, range 40-79n.a.Histologically proven adenocarcinoma of the papilla Vateri, the pancreatic head and distal bile ductn.a.n.a.n.a.Nikou et al. HYPERLINK \l "_ENREF_18" \o "Nikou, 2001 #2481" ADDIN EN.CITE Nikou200124812481248117Nikou, G. C.Tsatali, E.Arnaoutis, T. P.Giamarellos-Bourboulis, E. J.Zoumboulis-Vafiadis, I.Polyzos, A.Katsilambros, N.1st Department of Propedeutic Medicine, Athens Medical School, University of Athens, Athens, Greece
1st Department of Propedeutic Medicine, Laiko General Hospital, 17 Aghiou Thoma Str., Athens 115 27, GreeceThe significance of the early detection of clinical symptoms in the overall survival of patients with pancreatic cancerAnnals of GastroenterologyAnnals of Gastroenterology33-36141Pancreatic cancerSurvival2001Articlehttps://www.scopus.com/inward/record.uri?eid=2-s2.0-34548331372&partnerID=40&md5=5ddb9cf8d967657ad82c7eadadb5797escopus_S1_ 1.6 Original studyScopus18Early clinical suspicion of cancer25n.a.n.a.Adenocarcinoma of the pancreasII: 12%; III: 8%; IV: 80%n.a.n.a.No initial clinical suspicion37II: 0%; III: 5.4%; IV: 94.6% Table S3. Key characteristics of the included studies
StudyDesignStudy sitesStudy yearsTotal NData on delayOutcomes reported by delayJooste et al. 3RC France,
2 registries + GP survey2009-2011450from symptom onset to first visit (mostly in primary care): threshold at 30 days; from first visit to treatment: threshold at 29 dayspresence of metastasis at diagnosis; mortality hazard rate (FU 3 years)Eshuis et al.14 HYPERLINK \l "_ENREF_18" \o "Eshuis, 2010 #2007" RCTThe Netherlands,
13 centers2003-2008185from symptom onset to randomization: median 3, IQR 2-5 weeks. From randomization to cancer surgery: 2 study arms. Early cancer surgery arm: median 1.2, IQR 0.9-1.5 weeks; Prior biliary drainage surgery arm: median 5.1, IQR 4.8-5.5 weeks.mortality hazard rate (FU 2 years); rate of resectability at surgery; rate of palliative bypass / exploration; rate of lymph node positivity at surgery; rate of microscopically residual disease at surgery; rate of surgery complicationsTokuda et al.16RCJapan,
1 center1991-200057from first symptom to first visit: median 21, IQR 4-60, mean 42.7, SD 52.5 days.delays in patients with / without distant metastasis at first diagnostic workupSanjeevi et al.5RCSweden,
1 center2008-2014349from imaging to reassessment/resection: median 42 days, range 10-159 days. Cut-offs for analysis at 22, 32, 36, 50, 64, 77 days. hazard of irresectabilityNikou et al.18PCGreece,
1 center1994-200065from first symptoms to first visit: median 1 and 1.4 months; and from first visit to correct diagnosis: median 0 and 3 months, in patients with correct and with incorrect initial diagnosis, respectively. overall survival (FU 5 years); stage distributionSwords et al.6RCUSA,
1 center2000-2010315from symptom onset to correct diagnosis: median 1.4, IQR 0.9-2.5 months with proper initial diagnosis, median 4.2, IQR 2.5-8.6 months in initially misdiagnosed casesrate of stage III-IV disease at diagnosis; rate of resectability; overall survivalGobbi et al.9RCItaly,
1 center2001-2010170from initial symptom to diagnosis: median 8.4, range 0.444.7 weeks. mortality hazard rate (FU 5 years)Amr et al.4RCUK,
5 centers2006-2014266from diagnostic imaging to surgery: threshold at 49 daysoverall survival (FU up to 8 years)Healy et al.1RCIreland,
1 center2010-2015239from abdominal CT to surgery: median 32.5, IQR 35, range 0254 days.overall and disease-specific survival (FU 2 years), mortality hazard rates; rate of curative resection, rate of local irresectability or abdominal metastasis; T stage, tumor size in mm, lymph node positivity, lymphovascular invasion.Raptis et al.15RCUK,
1 center1997-2002355from symptom onset to GP referral letter: median 65, IQR 31-143 days; from referral letter to referral: median 17, IQR 8-28 days; from referral to diagnosis/treatment: median 11, IQR 6-21 days. mortality hazard rate (FU 5 years); survival at 1, 3, and 5 years by delay quintiles; rate of resectability; rate of operabilityMcLean et al.10RCCanada,
1 center2000-2008193from surgical consultation to surgery: cut-offs at 14, 30, and 60 days; detailed data on delays in resectable and unresectable patients. delays in resectable / non-resectable patients; T status; N positivity; resection margin positivity; survival (FU 5 years). Marchegiani et al.2RCItaly,
1 center2010-2014217from diagnosis to surgery: median 29, range 1-230 days; cut-off at 30, 45, or 60 days.increase in tumor size from preoperative CT to pathology (primary parameter); tumor stage, rate of R1 resections; overall survival (FU median 1.5 years), mortality hazard rateYun et al.12RCSouth Korea,
population registry2001-20052309from diagnosis to treatment initiation: cut-off at 31 daysmortality hazard rate (FU 5 years)Deriban et al.11PCMacedonia, 1 centern.a.50from jaundice to ERCP: 3 subgroups <2 weeks, in 2-4 weeks, in >4 weeksrate of successful cannulation rate of successful stent insertionGhadimi et al.17RCGermany,
1 center1994-2000186from cholecystectomy in 17 misdiagnosed cases to cancer diagnosis: median 5, IQR 2-10 monthsrate of curative resection; rate of palliative resection. Driedger et al.7RCCanada,
1 center2008-2012133from first imaging to surgery: cohorts by number of extra imaging tests. 0: mean 45.4; +1: mean 53.4; +2: mean 61.0; +3: mean 81.4; +4: mean 122.6 daysrate of surgery of any type (resection or palliative);
rate of palliative surgeryGlant et al.13RCUSA,
1 center2004-2009487from most recent cross-sectional imaging to surgery: cut-offs at 7, 14, 21, 28, 35, 42, and 49 days.rate of biopsy proven metastasis at surgery; for resected tumors: tumor size, grade, N positivity, vascular invasion, perineural invasion.Raman et al.8RCUSA,
1 center2006-2007256from multidetector CT scan to surgery: median 15.5, range 1-198 days; cut-offs at 5, 10, 15, 20, 25, and 30 days.rate of metastases at surgery; sensitivity, specificity, positive and negative predictive value of multidetector CT to detect metastatic disease. ERCP, endoscopic retrograde cholangio-pancreatography; FU, follow-up; GP, general practitioner; IQR, interquartile range; PC, prospective cohort; RC, retrospective cohort; RCT, randomized controlled trial.
Table S4. Narrative summary of study findings
Studies measuring delay from symptom onsetJooste et al. HYPERLINK \l "_ENREF_3" \o "Jooste, 2016 #1674" ADDIN EN.CITE ADDIN EN.CITE.DATA 3Jooste et al investigated the association of patient and treatment delays with metastasis at diagnosis, and with overall mortality in a retrospective cohort of 554 pancreatic cancer patients recorded in two Fre n c h c a n c e r r e g i s t r i e s . P a t i e n t d e l a y d a t a w a s c o l l e c t e d a s c a t e g o r i c a l d a t a ( < 1 o r e"1 m o n t h ) f r o m g e n e r a l p r a c t i t i o n e r s . T r e a t m e n t d e l a y w a s a l s o d i c h o t o m i z e d , a s l e s s o r m o r e t h a n t h e m e d i a n t i m e o f 2 9 d a y s . H i g h e s t r a t e o f c u r a t i v e r e s e c t i o n o c c u r r e d i n t h e g r o u p w i t h s h o r t e r p a t i e n t a n d t r e a t m e n t d e l a y s ( 5 2 % , v s . 1 4 % , 8 % a n d 2 6 % i n o t h e r g r o u p s ; p = 0 . 0 1 1 ) . H o w e v e r , i n m u l t i v a r i a t e a n a l y s i s , t r e a t m e n t d e l a y e"2 9 d a y s s h o w e d a p a r a d o x , i n v e r s e a s s o c i a t i o n w i t h p o s i t i v e m e t a s t a s i s s t a t u s ( O R 0 . 5 , 9 5 % C I 0 . 3 - 0 .9) when adjusted for age, sex, Charlson comorbidity index, symptoms, first practitioner, treatment type (surgery, medical bypass, or chemo/radiotherapy), and European Deprivation Index (EDI) quintiles. Overall delay categories were not significantly associated with 3-year mortality in multivariate Cox regression analysis adjusted for age, sex, stage/radicality of surgery (M0 with R0, M0 without R0, M1), and EDI quintiles. Swords et al. HYPERLINK \l "_ENREF_6" \o "Swords, 2015 #1716" ADDIN EN.CITE ADDIN EN.CITE.DATA 6Swords et al conducted a retrospective cohort study of 313 patients with proximal PDAC in a US center, and compared stage distribution and resectability of patients with correct initial diagnosis (N=215) to patients with initial misdiagnosis (N=98). The median diagnostic delay was 0.6 (IQR 0.3-1.2) and 3.5 (IQR 1.6-6.3) months in these subgroups, respectively (Wilcoxon rank sum test p<0.001). Median time from first symptom to first visit was similar across subgroups (0.7 month, IQR 0.3-1.4 and 0.5 month, IQR 0.2-1.4, respectively). Patients with initial misdiagnosis were more likely to have a stage III-IV disease when diagnosed (61.2% vs. 43.7%, relative risk: 1.4, 95 %CI 1.121.74). Resection rates and median overall survival was not statistically different across groups in chi-squared and log-rank tests, respectively. Gobbi et al. HYPERLINK \l "_ENREF_9" \o "Gobbi, 2013 #1879" ADDIN EN.CITE ADDIN EN.CITE.DATA 9Gobbi et al conducted a retrospective chart review of 170 patients with newly diagnosed pancreatic cancer in an Italian cancer center, looking for the association of overall survival with time from symptom onset to diagnosis. The median time from first symptom to diagnosis was 8.4 weeks, range 0.4 to 44.7 weeks; and the median survival was 8.6 months (95%CI 7.1-10.2 months). In Kaplan-Meyer analysis, overall survival was highest in patients with delay <4 weeks, lower in patients with a 4-16 weeks delay, and worst in patients with a delay of >16 weeks (p<0.0001 in log-rank test). In multivariate Cox regression analysis, mortality HR for a 1-week delay of diagnosis was 1.0240 (95%CI 1.0117-1.0365) when adjusted for age, sex, histology, tumor site within pancreas, tumor stage, tumor size in cm, and resectability, and stratified by chemotherapy. Deriban et al. HYPERLINK \l "_ENREF_11" \o "Deriban, 2012 #1876" ADDIN EN.CITE Deriban201218761876187617Deriban, G.Andreevski, B.Mishevski, J.Krstevski, M.Trajkovska, M.Popova, R.Joksimovic, N.Serafimoski, V.University Gastroenterohepatology Clinic, Medical Faculty, Skopje, R. Macedonia.Obstructive jaundice caused by pancreatic head malignancies are there predictive factors for successful endoscopic biliary stenting?PriloziPriloziPriloziPriloziPriloziPrilozi59-713322013/02/22AdultAgedAged, 80 and over*Cholangiopancreatography, Endoscopic RetrogradeFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complicationsProspective Studies*StentsTreatment Outcome20120351-3254 (Print)
0351-3254234258701.3 Not relevant topic1.6 Original studyScreening S1.6NLMeng11Deriban et al reported their experience with cannulation and stent insertion in a prospective cohort of 50, mostly irresectable patients in Macedonia with primary pancreato-biliary malignancies of the pancreatic head. Delay defined as time from onset of jaundice to ERCP was in 2 weeks in N=20, in 2-4 weeks in N=26, and beyond 4 weeks in 4 patients. Altogether, cannulation and stenting were successful in 86% and in 70%, respectively. Stent insertion was successful in 80%, 69%, and 25% and cannulation was successful in 90%, 84.6%, and 75% in patients with <2 weeks delay, 2-4 weeks delay, and >4 weeks delay of ERCP, respectively. No statistical tests were reported. Raptis et al. HYPERLINK \l "_ENREF_15" \o "Raptis, 2010 #2021" ADDIN EN.CITE ADDIN EN.CITE.DATA 15Raptis et al described a retrospective chart review of 355 PDAC patients in a UK university hospital, and compared overall survival rates at 1, 3, and 5 years after diagnosis/treatment across patient subgroups below or above prespecified delay thresholds. Three periods of delay were considered: time from symptom onset to the date of the letter referring the patient to the Pancreatic Unit of the Hospital (T1); the time from the referral date to the date of review at the Unit (either clinic appointment or admission for investigations, whichever came first) (T2); and time from date of review to the date of diagnosis/treatment (T3). Median (IQR) lengths for T1, T2, and T3 periods were 65 (31 143) days, 17 (8 28) days, and 11 (10 21) days, respectively. Median T1+T2+T3 duration was 102 days (IQR 56 182). The median survival was not statistically different across patients with T1 <31 days and T1 >31 days (8 month in both groups, p=0.492) or across patients with T1 <65 days and T1 >65 days (8 and 6 months, p=0.18), but a statistically significant difference was found between patients with T1 <143 days and T1 >143 days (8 and 6 months, p=0.014). Operability rates were 32% and 19% (p=0.039), and resectability rates were 34% and 21% (p=0.379) in these subgroups, respectively. There were no significant differences in operability, resectability, or median survival across patients with T2+T3 <62 days and patients with T2+T3 >62 days. In multivariate Cox regression analysis when age, sex, jaundice, abdominal pain, weight loss, T1 duration, T2+T3 duration, resectability, and inoperability were included only resectability and time from symptoms to referral turned to be statistically significant predictors of survival.Tokuda et al. HYPERLINK \l "_ENREF_16" \o "Tokuda, 2009 #2477" ADDIN EN.CITE Tokuda200924772477247717Tokuda, Y.Chinen, K.Obara, H.Joishy, S. K.Center for Clinical Epidemiology, St Luke's Life Science Institute, Tokyo. tokuyasu@orange.ocn.ne.jpIntervals between symptom onset and clinical presentation in cancer patientsIntern MedInternal medicine (Tokyo, Japan)Intern MedInternal medicine (Tokyo, Japan)Intern MedInternal medicine (Tokyo, Japan)899-90548112009/06/02AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasm Metastasis/diagnosis/therapyNeoplasms/ diagnosis/ therapyRegistriesRetrospective StudiesTime FactorsYoung Adult20091349-7235 (Electronic)
0918-2918 (Linking)19483358Screening C1.6NLMeng16Tokuda et al compared the periods from first symptom to first patient visit in a healthcare institution for their cancer-related symptoms, with or without identified metastasis at first diagnostic workup (including imaging studies, operative findings, or histological documentations) in a retrospective cohort study of 57 pancreatic cancer patients in a cancer center in Japan. The mean symptom to visit interval was 52.5 days (SD 58.3) in metastatic and 29.4 days (SD 40.6) in non-metastatic pancreatic cancer patients. The difference was statistically not significant in Students t test.Studies measuring delay from first specialist consultationGhadimi et al. HYPERLINK \l "_ENREF_17" \o "Ghadimi, 2002 #2347" ADDIN EN.CITE Ghadimi200223472347234717Ghadimi, B. M.Horstmann, O.Jacobsen, K.Feth, J.Becker, H.Dept. of Surgery, University Medical Center Gottingen, Georg-August-University Gottingen, Germany.Delay of diagnosis in pancreatic cancer due to suspected symptomatic cholelithiasisScand J GastroenterolScandinavian journal of gastroenterologyScand J GastroenterolScandinavian journal of gastroenterologyScand J GastroenterolScandinavian journal of gastroenterology1437-937122003/01/14Adenocarcinoma/*diagnosis*Ampulla of VaterCholecystectomy/statistics & numerical dataCholelithiasis/*complicationsCommon Bile Duct Neoplasms/*complicationsHumansMiddle AgedPancreatic Neoplasms/*diagnosisTime FactorsWeight Loss2002Dec0036-5521 (Print)
0036-5521125235941.6 Original study1.6 Original studyScreening C1.6NLMeng17Ghadimi et al compared the rate of curative resection between patients with correct initial diagnosis and initial misdiagnosis (suspected cholelithiasis and cholecystectomy surgery) of pancreatic cancer patients in a cancer center in Germany. Initial misdiagnosis resulted in additional diagnostic delay (median 5 months, IQR 2-10 months, range 1 month to 2 years) in 9% of all pancreatic cancer patients (17 of 186 cases). The rate of curative resection was 35% in the misdiagnosed subgroup versus 44% in the whole series. The rate of palliative resection was 24% in the misdiagnosed subgroup versus 10% in the whole series. No statistical tests were reported. Nikou et al. HYPERLINK \l "_ENREF_18" \o "Nikou, 2001 #2481" ADDIN EN.CITE Nikou200124812481248117Nikou, G. C.Tsatali, E.Arnaoutis, T. P.Giamarellos-Bourboulis, E. J.Zoumboulis-Vafiadis, I.Polyzos, A.Katsilambros, N.1st Department of Propedeutic Medicine, Athens Medical School, University of Athens, Athens, Greece
1st Department of Propedeutic Medicine, Laiko General Hospital, 17 Aghiou Thoma Str., Athens 115 27, GreeceThe significance of the early detection of clinical symptoms in the overall survival of patients with pancreatic cancerAnnals of GastroenterologyAnnals of Gastroenterology33-36141Pancreatic cancerSurvival2001Articlehttps://www.scopus.com/inward/record.uri?eid=2-s2.0-34548331372&partnerID=40&md5=5ddb9cf8d967657ad82c7eadadb5797escopus_S1_ 1.6 Original studyScopus18Nikou et al reported a prospective cohort study of 62 patients with pancreatic adenocarcinoma in a single center in Greece. Patients with initial clinical suspicion of cancer (N=25) were compared with patients without initial suspicion of cancer (N=37). In patients without initial cancer suspect, the median delay of diagnosis was 3 months longer (p<0.001). Most patients were in advanced stage at diagnosis in both groups (stage III-IV in 88% with and 100% without correct initial suspect, p=0.048). The median survival of stage IV patients (N=20 and N=30, respectively) from presentation of symptoms was 6.5 months and 4.0 months, respectively (p=0.025). Studies measuring delay from cross-sectional imagingHealy et al. HYPERLINK \l "_ENREF_1" \o "Healy, 2018 #2474" ADDIN EN.CITE ADDIN EN.CITE.DATA 1Healy et al reported a retrospective cohort study of 239 patients undergoing surgical exploration for pancreatic ductal adenocarcinoma or periampullary adenocarcinoma with curative intent at St. Vincents University Hospital, Ireland. Periampullary cancers with intestinal histology were excluded. All patients were classified as resectable at abdominal CT before surgery. Patients with unexpected disease progression at surgery (N= 2 9 ) h a d l o n g e r C T t o s u r g e r y p e r i o d ( m e d i a n 4 6 v s . 2 9 d a y s , I Q R s 3 5 a n d 3 4 d a y s , p = 0 . 0 0 5 ) . I m a g i n g t o s u r g e r y i n t e r v a l w a s e"2 5 d a y s i n 5 5 % o f r e s e c t e d v s . 7 9 % o f u n e x p e c t e d p r o g r e s s i o n p a t i e n t s ( p = 0 . 0 1 6 ) . I n t h e P D A C s u b g r o u p , n e i t h e r d i s e a s e - f r e e n o r o v e rall survival were associated with imaging to surgery interval in univariate Cox regression analyses. Multivariate Cox regression analyses did not include the imaging to surgery interval. Marchegiani et al. HYPERLINK \l "_ENREF_2" \o "Marchegiani, 2017 #2479" ADDIN EN.CITE Marchegiani201724792479247917Marchegiani, G.Andrianello, S.Perri, G.Secchettin, E.Maggino, L.Malleo, G.Bassi, C.Salvia, R.Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, ItalyDoes the surgical waiting list affect pathological and survival outcome in resectable pancreatic ductal adenocarcinoma?HPBHPBhttps://doi.org/10.1016/j.hpb.2017.10.0172017Article in Presshttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85035203960&doi=10.1016%2fj.hpb.2017.10.017&partnerID=40&md5=983ca9b5649b7d2cdd196fed9d6066f9scopus_S1_ 1.6 Original study10.1016/j.hpb.2017.10.017Scopus2Marchegiani et al. conducted a retrospective analysis of 217 resectable PDAC patient in an Italian center with complete data. Time from preoperative CT to surgery was dichotomized with a cut-off at 30 days. In patients with surgical wait ti m e > 3 0 d a y s ( N = 1 0 5 ) , t u m o r i n c r e a s e f r o m r a d i o l o g y t o p a t h o l o g y w a s s i g n i f i c a n t l y l a r g e r ( m e d i a n 3 v s . 1 m m , p = 0 . 0 4 ) . N o s i g n i f i c a n t d i f f e r e n c e w a s f o u n d i n t u m o r s t a g e o r r e s e c t i o n s u c c e s s ( R 0 / R 1 / R 2 ) b e t w e e n s u b g r o u p s w i t h > 3 0 a n d d"3 0 d a y s s u r g e r y d e l a y . Similar findings were reported applying a threshold at 45 days. Surgery wait time above thresholds at 30, 45, or 60 days was not significantly associated with mortality hazard in univariate Cox regression models and not tested in multivariate models. However, in a sensitivity analysis of patients with <20 mm tumor size, surgery delay >30 days was significantly associated with overall mortality (p=0.02 in log rank test). Macroscopically incomplete resections were excluded from all survival analyses. Amr et al. HYPERLINK \l "_ENREF_4" \o "Amr, 2016 #1678" ADDIN EN.CITE ADDIN EN.CITE.DATA 4Amr et al reported a retrospective cohort study of 266 patients undergoing periampullary cancer resection in five UK hospitals. In the subgroup of pancreatic cancer patients (N=149), the median imaging to surgery period (time from first imaging test with cancer suspect to surgery) was 48 days, range 1-551 days. Lymph nodes were involved in 85.2% and resection margin was positive in 79.9% in this subgroup. Overal l s u r v i v a l w a s n o t a s s o c i a t e d w i t h i m a g i n g t o s u r g e r y i n t e r v a l w h e n p a t i e n t s w i t h > 4 9 d a y s a n d d"4 9 d a y s i n t e r v a l s w e r e c o m p a r e d i n u n i v a r i a t e C o x r e g r e s s i o n a n a l y s i s . S a n j e e v i e t a l . H Y P E R L I N K \ l " _ E N R E F _ 5 " \ o " S a n j e e v i , 2 0 1 6 # 1 7 0 2 " A D D I N E N . C I T E ADDIN EN.CITE.DATA 5Sanjeevi et al conducted a retrospective cohort study of 349 surgical candidate patients with periductal adenocarcinoma of the pancreas at the Karolinska University Hospital in Sweden, looking for the association of imaging-to-resection/reassessment (IR) interval with progression to locally advanced/metastatic disease incompatible with curative resection. IR period was defined as time from diagnostic imaging (the basis for the multidisciplinary tumor board assessment) to reassessment (reimaging or surgical assessment at laparotomy). Median IR was 42 days, range 10-159 days. Of the 349 patients, 9 were unresectable based on radiological reassessment and 73 based on intraoperative surgical assessment. Unresectability rate was zero in p a t i e n t s w i t h I R d"2 2 d a y s , a n d w a s s i g n i f i c a n t l y l o w e r f o r a n I R i n t e r v a l d"3 2 d a y s c o m p a r e d w i t h l o n g e r w a i t i n g t i m e s ( H R 0 . 4 2 , 9 5 % C I 0 . 2 1 - 0 . 8 9 ) . I n p a t i e n t s w i t h r e s e c t i o n s u r g e r y , I R i n t e r v a l d"3 2 d a y s w a s n o t s i g n i f i c a n t l y a s s o c i a t e d w i t h r e d u c e d m o r t a lity hazard (HR 0.88, 95%CI 0.61-1.26). Driedger et al. HYPERLINK \l "_ENREF_7" \o "Driedger, 2015 #1737" ADDIN EN.CITE ADDIN EN.CITE.DATA 7Driedger et al investigated the impact of repeated imaging tests on treatment delay and tumor resectability in a retrospective cohort of 150 patients in a Canadian center with a solid pancreatic lesion concerning for a pancreatic adenocarcinoma on diagnostic imaging. Mean times from first imaging for suspected pancreatic cancer to the day of surgery were 45.4, 53.4, 61.0, 81.4, and 122.6 days in patients without and with 1, 2, 3, or 4 additional imaging tests, respectively. As the number of tests increased, the proportion of patients undergoing surgery of any type was unchanged, but the proportion of patients undergoing non-resective surgery increased (p < 0.05). Raman et al. HYPERLINK \l "_ENREF_8" \o "Raman, 2015 #2473" ADDIN EN.CITE ADDIN EN.CITE.DATA 8Raman et al studied the negative predictive value of multi-detector CT (MDCT) scanning for unexpected metastases in a retrospective cohort of 256 patients who underwent MDCT and any operative intervention for pancreatic adenocarcinoma in a USA center. Median time between the most recent MDCT scan and surgery was 15.5 days (range 1198 days). MDCT was statistically significantly less accurate at predicting the absence of metastatic disease when performed more than 25 days before surgery (77.0% vs. 89.3%, p = 0.0097). The negative predictive value decreased even further to 72.6% in patients with >30 days delay of surgery (p = 0.004). McLean et al. HYPERLINK \l "_ENREF_10" \o "McLean, 2013 #2464" ADDIN EN.CITE ADDIN EN.CITE.DATA 10McLean et al reported a retrospective chart review of 193 patients with periampullary adenocarcinoma of various origin, all deemed resectable at preoperative surgery consultation in a Canadian center. Of the 193 patients, 74 turned to be unresectable at operation. Mean time from surgical consult to operation was 41 (SD 34) and 39 (SD 29) days in the resectable and unresectable groups (NS). Time from symptom onset to surgery consultation was also similar across groups (37 48 and 50 97 days, respectively). In resected cases, no statistically significant difference was found in T stage, N stage, and resection margin positivity between patients with >30 days and d"3 0 d a y s f r o m s u r g e r y c o n s u l t a t i o n t o o p e r a t i o n i n c h i - s q u a r e d t e s t s . S u r v i v a l o f p a t i e n t s w i t h < 3 0 d a y s a n d > 3 0 d a y s t r e a t m e n t d e l a y w a s s i m i l a r i n K a p l a n - M e y e r a n a l y s i s a n d l o g - r a n k t e s t . G l a n t e t a l . H Y P E R L I N K \ l " _ E N R E F _ 1 3 " \ o " G l a n t , 2 0 1 1 # 2 4 6 7 " ADDIN EN.CITE ADDIN EN.CITE.DATA 13Glant et al investigated whether the number of days elapsed from the most recent cross-sectional CT / MR scan to operation (imaging to operation interval, IOI) was associated with higher rate of unanticipated metastasis encountered during operation in a cancer center in the USA. The study enrolled 329 pancreatic adenocarcinoma patients without evidence of metastasis on preoperative cross-sectional imaging and with a defined imaging date, including 293 patients with proximal (head, proximal neck, uncinate process) and 36 with distal (body, tail) tumor of the pancreas. In patients with proximal tumor, the rate of unexpected metastasis was 12% in IOI ranges of 0-6, 7-13, or 14-20 days; while it was 35%, 29%, and 30% when IOI was in the 35-41, 42-48, and 49-86 days ranges, respectively. In the IOI range of 14 to 41 days, a strong linear regression was observed between unexpected metastasis rates and additional weeks of IOI (12%, 20%, 25%, and 35%, R2 = 0.99, p=0.006). Mean IOI was 19 and 25 days in non-metastatic and metastatic proximal pancreas cancer patients (p=0.007). In patients with distal tumors, the rate of unexpected metastasis at operation was 22%, no clear trend was observed by IOI intervals, and the mean IOI was similar across non-metastatic and metastatic patients (32 and 29 days, p = 0.67). Eshuis et al. HYPERLINK \l "_ENREF_14" \o "Eshuis, 2010 #2007" ADDIN EN.CITE ADDIN EN.CITE.DATA 14Eshuis et al reported a multicenter randomized controll e d t r i a l i n 1 8 5 p a t i e n t s w i t h c a n c e r o f t h e p a n c r e a t i c h e a d w h o h a d n o C T e v i d e n c e o f l o c o r e g i o n a l i r r e s e c t a b l e o r m e t a s t a t i c d i s e a s e a n d h a d a s e r u m t o t a l b i l i r u b i n l e v e l o f 4 0 t o 2 5 0 m o l / L . P a t i e n t s w e r e r a n d o m l y a s s i g n e d t o e a r l y s u r g e r y ( E S a r m , N = 9 0 ) or preoperative biliary drainage (PBD arm, N=95) within 4 days after CT. The time from randomization to cancer surgery was 1.2 weeks (95%CI 0.9 1.5) and 5.1 weeks (95%CI 4.8 5.5) in the ES and PBD arms, respectively. No statistically significant between-arm differences were observed in resectability, nodal status, microscopically residual disease, or median survival time. Multivariate Cox regression analysis of all patients undergoing resection, palliative gastrointestinal bypass or explorative surgery (N=180) showed a paradox association of higher mortality hazard rate with shorter treatment delays when adjusted for age, sex, bilirubin quartiles, surgery type (resection/other), blood transfusions, and surgery/PBD complications (HR for 1-week increment in treatment delay: 0.91, 95%CI 0.84 0.99). A similar, paradox association was reported in the multivariate Cox regression analysis of a patient subgroup undergoing resection (N=113) when adjusted to the above parameters plus histology (adenocarcinoma), tumor positive lymph nodes (N1), and microscopically residual disease (R1). The mortality HR for 1-week increment in treatment delay was 0.85 (95%CI 0.75 0.96) in this analysis. Studies measuring delay from cancer diagnosisYun et al. HYPERLINK \l "_ENREF_12" \o "Yun, 2012 #1924" ADDIN EN.CITE ADDIN EN.CITE.DATA 12Yun et al reported a population-based study in South Korea, based on the Korea Central Cancer Registry and the National Health Insurance claims database. The study enrolled 2309 p a t i e n t s w i t h p a n c r e a t i c c a n c e r w h o u n d e r w e n t a n y t y p e o f s u r g e r y . O n l y t r e a t m e n t d e l a y w a s c o n s i d e r e d , f r o m c a n c e r d i a g n o s i s t o i n i t i a t i o n o f t r e a t m e n t , w i t h a p r e d e f i n e d t h r e s h o l d a t 3 1 d a y s . T r e a t m e n t d e l a y w a s d"3 1 d a y s i n 1 9 9 9 p a t i e n t s ( 8 6 . 6 % ) . F i v e - y ear mortality hazard rate in patients with >31 days delay was 1.33 (95%CI 1.16-1.53) in univariate and 1.23 (95%CI 1.07-1.41) in multivariate Cox regression analysis adjusted for age, sex, Charlson scale, hospital type, insurance, radiotherapy, chemotherapy, type of medical care institution, year of diagnosis, and hospital volume (dichotomized by at least 5 pancreatic cancer operation per year). In a sensitivity analysis, the interaction of treatment delay and alternatively defined hospital volume (at least 11 pancreatic cancer operation per year) was investigated, adjusted for age, sex, Charlson scale, hospital type, insurance, radiotherapy, chemotherapy, type of medical care institution, year of diagnosis. In this sensitivity analysis, the adjusted HR for patients with delay was 1.07 (95%CI 0.84-1.36) and 1.60 (95%CI 1.33-1.92) in high and low volume hospitals, respectively.
Table S5. Bias assessment in cohort studies (MINORS score)
Scoring: 0 (not reported), 1 (reported but inadequate), 2 (reported and adequate). The global ideal score is 16 for non-comparative studies and 24 for comparative studies.
Source: Slim et al.20; text in italics at items 2,10, and 12 reflect adaptation/interpretation by the authors of this paper.Deshwar 2018 19Healy 2018 1Marchegiani 2017 2Jooste 2016 3Amr 2016 4Sanjeevi 2016 5Swords 2015 6Driedger 2015 7 Raman 2015 8McLean 2013 10Gobbi 2013 9
Deriban 2012 11Yun 2012 12Glant 2011 13Raptis 2010 15Tokuda 2009 16Ghadimi 2002 17Nikou 2001 18A clearly stated aim: The question addressed should be precise and relevant in the light of available literature.222222222221222222Inclusion of consecutive patients: All patients potentially fit for inclusion (satisfying the criteria for inclusion) have been included in the study during the study period (no exclusion or details about the reasons for exclusion). Studies with risk of length bias are scored as 1. 121112222210121222Prospective collection of data: Data were collected according to a protocol established before the beginning of the study. 222222222222222222Endpoints appropriate to the aim of the study: unambiguous explanation of the criteria used to evaluate the main outcome which should be in accordance with the question addressed by the study. Also, the endpoints should be assessed on an intention-to-treat basis.122222222222222222Unbiased assessment of the study endpoint: Blind evaluation of objective endpoints and double-blind evaluation of subjective endpoints. Otherwise the reasons for not blinding should be stated. 000001000000100000Follow-up period appropriate to the aim of the study: The follow-up should be sufficiently long to allow the assessment of the main endpoint and possible adverse events. 222222222222222222Loss to follow up less than 5%: All patients should be included in the follow up. Otherwise, the proportion lost to follow up should not exceed the proportion experiencing the major endpoint. 222222222222222222Prospective calculation of the study size: Information of the size of detectable difference of interest with a calculation of 95% confidence interval, according to the expected incidence of the outcome event, and information about the level for statistical significance and estimates of power when comparing the outcomes. 000000000000000000An adequate control group (comparative studies only): Having a gold standard diagnostic test or therapeutic intervention recognized as the optimal intervention according to the available published data.222222222222222122 Contemporary groups (comparative studies only): Control and studied group should be managed during the same time period (no historical comparison). Studies with 10+ years of enrolment are scored as 1.222222122212222122Baseline equivalence of groups (comparative studies only): The groups should be similar regarding the criteria other than the studied endpoints. Absence of confounding factors that could bias the interpretation of the results. 021100100
000020001Adequate statistical analyses (comparative studies only): Whether the statistics were in accordance with the type of study with calculation of confidence intervals or relative risk. Studies reporting analyses not adjusted for known and measured confounders are scored as 1; studies without statistical analyses are scored as 0. 221212111120212101Total score162017181619171717171613181917151618Table S6. PRISMA checklist (Source: [21])
Section/topic #Checklist item Reported on page # TITLE Title 1Identify the report as a systematic review, meta-analysis, or both. 1ABSTRACT Structured summary 2Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number. unstructured abstractINTRODUCTION Rationale 3Describe the rationale for the review in the context of what is already known. 2 4Objectives 4Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS). 4, 6METHODS Protocol and registration 5Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number. 6Eligibility criteria 6Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale. 6Information sources 7Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched. 6; Table S1Search 8Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated. Table S1Study selection 9State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis). 6 7Data collection process 10Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators. 6 7Data items 11List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made. 6 7Risk of bias in individual studies 12Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis. 7 8Summary measures 13State the principal summary measures (e.g., risk ratio, difference in means). NA (not restricted to specific outcomes)Synthesis of results 14Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis. 22 (narrative synthesis)Risk of bias across studies 15Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies). NA (no quantitative synthesis)Additional analyses 16Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified. NA (no quantitative synthesis)RESULTS Study selection 17Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram. Figure 1Study characteristics 18For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations. Tables S2 S3Risk of bias within studies 19Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). Figure 2, DiscussionResults of individual studies 20For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot. Table 3Synthesis of results 21Present results of each meta-analysis done, including confidence intervals and measures of consistency. NARisk of bias across studies 22Present results of any assessment of risk of bias across studies (see Item 15). NAAdditional analysis 23Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16]). NADISCUSSION Summary of evidence 24Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers). 20 25Limitations 25Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias). 24Conclusions 26Provide a general interpretation of the results in the context of other evidence, and implications for future research. 24 25 FUNDING Funding 27Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review. 25
References to Supplementary Information
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10. McLean SR, Karsanji D, Wilson J, Dixon E, Sutherland FR, Pasieka J, Ball C, Bathe OF. The effect of wait times on oncological outcomes from periampullary adenocarcinomas. J Surg Oncol 2013;107:853-8.
11. Deriban G, Andreevski B, Mishevski J, Krstevski M, Trajkovska M, Popova R, Joksimovic N, Serafimoski V. Obstructive jaundice caused by pancreatic head malignancies are there predictive factors for successful endoscopic biliary stenting? Prilozi 2012;33:59-71.
12. Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, Choi IJ, Kim YW, Park SJ, Kim JH, Lee DH, Yoon SJ, et al. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol 2012;23:2731-7.
13. Glant JA, Waters JA, House MG, Zyromski NJ, Nakeeb A, Pitt HA, Lillemoe KD, Schmidt CM. Does the interval from imaging to operation affect the rate of unanticipated metastasis encountered during operation for pancreatic adenocarcinoma? Surgery 2011;150:607-16.
14. Eshuis WJ, van der Gaag NA, Rauws EA, van Eijck CH, Bruno MJ, Kuipers EJ, Coene PP, Kubben FJ, Gerritsen JJ, Greve JW, Gerhards MF, de Hingh IH, et al. Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage. Ann Surg 2010;252:840-9.
15. Raptis DA, Fessas C, Belasyse-Smith P, Kurzawinski TR. Clinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancer. Surgeon 2010;8:239-46.
16. Tokuda Y, Chinen K, Obara H, Joishy SK. Intervals between symptom onset and clinical presentation in cancer patients. Intern Med 2009;48:899-905.
17. Ghadimi BM, Horstmann O, Jacobsen K, Feth J, Becker H. Delay of diagnosis in pancreatic cancer due to suspected symptomatic cholelithiasis. Scand J Gastroenterol 2002;37:1437-9.
18. Nikou GC, Tsatali E, Arnaoutis TP, Giamarellos-Bourboulis EJ, Zoumboulis-Vafiadis I, Polyzos A, Katsilambros N. The significance of the early detection of clinical symptoms in the overall survival of patients with pancreatic cancer. Annals of Gastroenterology 2001;14:33-6.
19. Deshwar A.B., et al., Diagnostic intervals and pancreatic ductal adenocarcinoma (PDAC) resectability: a single-center retrospective analysis. Ann Pancreat Cancer 2018;1.pii:8; doi: 10.21037/apc.2018.02.01.
20. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies(MINORS): development and validation of a new instrument. ANZ J Surg 2003;73:712-6.
21. Moher D., et al., Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6(7): e1000097. doi:10.1371/journal.pmed1000097
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Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Histopathology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Pancreatic Surgery, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.Preoperative CT in patients with surgically resectable pancreatic adenocarcinoma: does the time interval between CT and surgery affect survival?Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)620-6284332017/07/122018Mar2366-0058 (Electronic)28695235Screening C1.610.1007/s00261-017-1254-9NLMeng f D Healy201824742474247417Healy, G. M.Redmond, C. E.Murphy, S.Fleming, H.Haughey, A.Kavanagh, R.Swan, N.Conlon, K. C.Malone, D. E.Ryan, E. R.Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. ger.healy@svuh.ie.
Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Histopathology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Pancreatic Surgery, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.Preoperative CT in patients with surgically resectable pancreatic adenocarcinoma: does the time interval between CT and surgery affect survival?Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)620-6284332017/07/122018Mar2366-0058 (Electronic)28695235Screening C1.610.1007/s00261-017-1254-9NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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l a pZ yt8MP @ D Jooste201616741674167417Jooste, V.Dejardin, O.Bouvier, V.Arveux, P.Maynadie, M.Launoy, G.Bouvier, A. M.CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Universite Bourgogne Franche-Comte, LNC UMR866, F-21000 Dijon, France.
University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
Breast and Gynaecologic Cancer Registry of Cote D'Or, Centre Georges-Francois Leclerc Comprehensive Cancer Care Centre, Dijon, F-21, France.
Registre Des Hemopathies Malignes De Cote D'Or, EA4184, University of Burgundy, Dijon, F-21, France.Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based studyInt J CancerInternational journal of cancerInt J CancerInternational journal of cancerInt J CancerInternational journal of cancer1073-8013952016/05/01AgedAged, 80 and overComorbidityDelayed DiagnosisFemaleHumansMaleMiddle AgedPancreatic Neoplasms/diagnosis/*epidemiology/mortality/therapyPopulation SurveillanceRisk FactorsSurvival Rate*Time-to-Treatmentcancer registryepidemiologypancreatic cancerpatient delaysurvivaltreatment delay2016Sep 010020-7136271303331.6 Original study1.6 Original studyScreening C1.610.1002/ijc.30166NLMeng @ D Jooste201616741674167417Jooste, V.Dejardin, O.Bouvier, V.Arveux, P.Maynadie, M.Launoy, G.Bouvier, A. M.CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Universite Bourgogne Franche-Comte, LNC UMR866, F-21000 Dijon, France.
University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
Breast and Gynaecologic Cancer Registry of Cote D'Or, Centre Georges-Francois Leclerc Comprehensive Cancer Care Centre, Dijon, F-21, France.
Registre Des Hemopathies Malignes De Cote D'Or, EA4184, University of Burgundy, Dijon, F-21, France.Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based studyInt J CancerInternational journal of cancerInt J CancerInternational journal of cancerInt J CancerInternational journal of cancer1073-8013952016/05/01AgedAged, 80 and overComorbidityDelayed DiagnosisFemaleHumansMaleMiddle AgedPancreatic Neoplasms/diagnosis/*epidemiology/mortality/therapyPopulation SurveillanceRisk FactorsSurvival Rate*Time-to-Treatmentcancer registryepidemiologypancreatic cancerpatient delaysurvivaltreatment delay2016Sep 010020-7136271303331.6 Original study1.6 Original studyScreening C1.610.1002/ijc.30166NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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l a pZ yt8MP D Amr201616781678167817Amr, B.Shahtahmassebi, G.Briggs, C. D.Bowles, M. J.Aroori, S.Stell, D. A.Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK. Electronic address: B.amr@nhs.net.
School of Science and Technology, Nottingham Trent University, Nottingham, NG1 4BU, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK.Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancyHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary Association354-91842016/04/03Adenocarcinoma/mortality/pathology/*surgeryAdultAgedAged, 80 and overAmpulla of Vater/pathology/*surgeryBile Duct Neoplasms/mortality/pathology/*surgeryChi-Square DistributionDatabases, FactualDuodenal Neoplasms/mortality/pathology/*surgeryFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm, ResidualOdds RatioPancreatic Neoplasms/mortality/pathology/*surgeryProportional Hazards ModelsRisk FactorsTime Factors*Time-to-TreatmentTreatment Outcome2016Apr1365-182x270372051.6 Original studyPMC48146111.6 Original studyScreening C1.610.1016/j.hpb.2015.10.013NLMeng D Amr201616781678167817Amr, B.Shahtahmassebi, G.Briggs, C. D.Bowles, M. J.Aroori, S.Stell, D. A.Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK. Electronic address: B.amr@nhs.net.
School of Science and Technology, Nottingham Trent University, Nottingham, NG1 4BU, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK.Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancyHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary Association354-91842016/04/03Adenocarcinoma/mortality/pathology/*surgeryAdultAgedAged, 80 and overAmpulla of Vater/pathology/*surgeryBile Duct Neoplasms/mortality/pathology/*surgeryChi-Square DistributionDatabases, FactualDuodenal Neoplasms/mortality/pathology/*surgeryFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm, ResidualOdds RatioPancreatic Neoplasms/mortality/pathology/*surgeryProportional Hazards ModelsRisk FactorsTime Factors*Time-to-TreatmentTreatment Outcome2016Apr1365-182x270372051.6 Original studyPMC48146111.6 Original studyScreening C1.610.1016/j.hpb.2015.10.013NLMeng O$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l 4
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Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Division of Surgery, Karolinska Institute, Stockholm, Sweden.
Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.Impact of delay between imaging and treatment in patients with potentially curable pancreatic cancerBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgery267-7510332015/11/18AdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/surgeryDiagnostic Imaging/*methodsDisease ProgressionFemaleFollow-Up StudiesHumansLaparotomyMaleMiddle AgedPancreatectomy/*methodsPancreatic Neoplasms/*diagnosis/surgeryPrognosisRetrospective StudiesTime Factors2016Feb0007-1323265725091.6 Original study1.6 Original studyScreening C1.610.1002/bjs.10046NLMeng \
D Sanjeevi201617021702170217Sanjeevi, S.Ivanics, T.Lundell, L.Kartalis, N.Andren-Sandberg, A.Blomberg, J.Del Chiaro, M.Ansorge, C.Department of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Division of Surgery, Karolinska Institute, Stockholm, Sweden.
Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.Impact of delay between imaging and treatment in patients with potentially curable pancreatic cancerBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgery267-7510332015/11/18AdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/surgeryDiagnostic Imaging/*methodsDisease ProgressionFemaleFollow-Up StudiesHumansLaparotomyMaleMiddle AgedPancreatectomy/*methodsPancreatic Neoplasms/*diagnosis/surgeryPrognosisRetrospective StudiesTime Factors2016Feb0007-1323265725091.6 Original study1.6 Original studyScreening C1.610.1002/bjs.10046NLMeng A$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l c
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l a pZ yt8MP r D Swords201517161716171617Swords, D. S.Mone, M. C.Zhang, C.Presson, A. P.Mulvihill, S. J.Scaife, C. L.Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. douglas.swords@hsc.utah.edu.
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at PresentationJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract1813-2119102015/08/20Abdominal Pain/etiologyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/complications/*pathologyCholecystectomy*Delayed Diagnosis*Diagnostic ErrorsFemaleGallbladder Diseases/diagnosis/surgeryGastroesophageal Reflux/diagnosisHumansJaundice/etiologyMaleMiddle AgedNeoplasm StagingPancreatic Neoplasms/complications/*pathologyPancreatitis/etiologyPeptic Ulcer/diagnosisRetrospective StudiesSurvival RateTime FactorsWeight LossDelay diagnosisMisdiagnosisPancreatic cancerPancreatic ductal adenocarcinomaStage2015Oct1091-255x262863681.6 Original study1.6 Original studyScreening C1.610.1007/s11605-015-2923-zNLMeng r D Swords201517161716171617Swords, D. S.Mone, M. C.Zhang, C.Presson, A. P.Mulvihill, S. J.Scaife, C. L.Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. douglas.swords@hsc.utah.edu.
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at PresentationJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract1813-2119102015/08/20Abdominal Pain/etiologyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/complications/*pathologyCholecystectomy*Delayed Diagnosis*Diagnostic ErrorsFemaleGallbladder Diseases/diagnosis/surgeryGastroesophageal Reflux/diagnosisHumansJaundice/etiologyMaleMiddle AgedNeoplasm StagingPancreatic Neoplasms/complications/*pathologyPancreatitis/etiologyPeptic Ulcer/diagnosisRetrospective StudiesSurvival RateTime FactorsWeight LossDelay diagnosisMisdiagnosisPancreatic cancerPancreatic ductal adenocarcinomaStage2015Oct1091-255x262863681.6 Original study1.6 Original studyScreening C1.610.1007/s11605-015-2923-zNLMeng T$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l 4
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D Driedger201517371737173717Driedger, M. R.Dixon, E.Mohamed, R.Sutherland, F. R.Bathe, O. F.Ball, C. G.Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: ball.chad@gmail.com.The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?J Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical research39-4319912015/05/09Adenocarcinoma/*diagnosis/surgeryAdultAgedAged, 80 and overAlbertaDelayed Diagnosis/*statistics & numerical dataFemaleHumansMaleMiddle AgedPancreatic Neoplasms/*diagnosis/surgeryPractice Patterns, Physicians'/*statistics & numerical dataReferral and Consultation/*statistics & numerical dataRetrospective StudiesTomography, X-Ray Computed/statistics & numerical data/utilizationUnnecessary Procedures/statistics & numerical data/*utilizationPancreatic cancerUnnecessary testing2015Nov0022-4804259532171.6 Original study1.6 Original studyScreening C1.610.1016/j.jss.2015.04.026NLMeng
D Driedger201517371737173717Driedger, M. R.Dixon, E.Mohamed, R.Sutherland, F. R.Bathe, O. F.Ball, C. G.Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: ball.chad@gmail.com.The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?J Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical research39-4319912015/05/09Adenocarcinoma/*diagnosis/surgeryAdultAgedAged, 80 and overAlbertaDelayed Diagnosis/*statistics & numerical dataFemaleHumansMaleMiddle AgedPancreatic Neoplasms/*diagnosis/surgeryPractice Patterns, Physicians'/*statistics & numerical dataReferral and Consultation/*statistics & numerical dataRetrospective StudiesTomography, X-Ray Computed/statistics & numerical data/utilizationUnnecessary Procedures/statistics & numerical data/*utilizationPancreatic cancerUnnecessary testing2015Nov0022-4804259532171.6 Original study1.6 Original studyScreening C1.610.1016/j.jss.2015.04.026NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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D Raman201524732473247317Raman, S. P.Reddy, S.Weiss, M. J.Manos, L. L.Cameron, J. L.Zheng, L.Herman, J. M.Hruban, R. H.Fishman, E. K.Wolfgang, C. L.1 Department of Radiology, Johns Hopkins University School of Medicine, JHOC 3251, 601 N Caroline St, Baltimore, MD 21287.Impact of the time interval between MDCT imaging and surgery on the accuracy of identifying metastatic disease in patients with pancreatic cancerAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyW37-4220412014/12/30Adenoma/ diagnostic imaging/surgeryAdultAgedEarly DiagnosisFemaleHumansImage Enhancement/ methodsLymphatic MetastasisMaleMiddle AgedMultidetector Computed Tomography/ methodsPancreatic Neoplasms/ diagnostic imaging/secondary/surgeryReproducibility of ResultsSensitivity and SpecificityTime Factors2015Jan1546-3141 (Electronic)
0361-803X (Linking)25539271PMC4872713Screening 1.6Nihms78540710.2214/ajr.13.12439NLMeng
D Raman201524732473247317Raman, S. P.Reddy, S.Weiss, M. J.Manos, L. L.Cameron, J. L.Zheng, L.Herman, J. M.Hruban, R. H.Fishman, E. K.Wolfgang, C. L.1 Department of Radiology, Johns Hopkins University School of Medicine, JHOC 3251, 601 N Caroline St, Baltimore, MD 21287.Impact of the time interval between MDCT imaging and surgery on the accuracy of identifying metastatic disease in patients with pancreatic cancerAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyW37-4220412014/12/30Adenoma/ diagnostic imaging/surgeryAdultAgedEarly DiagnosisFemaleHumansImage Enhancement/ methodsLymphatic MetastasisMaleMiddle AgedMultidetector Computed Tomography/ methodsPancreatic Neoplasms/ diagnostic imaging/secondary/surgeryReproducibility of ResultsSensitivity and SpecificityTime Factors2015Jan1546-3141 (Electronic)
0361-803X (Linking)25539271PMC4872713Screening 1.6Nihms78540710.2214/ajr.13.12439NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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l a pZ yt8MP D Gobbi201318791879187917Gobbi, P. G.Bergonzi, M.Comelli, M.Villano, L.Pozzoli, D.Vanoli, A.Dionigi, P.Internal Medicine and Gastroenterology, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. gobbipg@smatteo.pv.itThe prognostic role of time to diagnosis and presenting symptoms in patients with pancreatic cancerCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiology186-903722013/02/02Adenocarcinoma/*diagnosis/therapyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/therapyCombined Modality TherapyDelayed DiagnosisFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPalliative CarePancreatic Neoplasms/*diagnosis/therapyPrognosisRetrospective StudiesRisk FactorsSurvival RateWeight Loss2013Apr1877-7821233694501.6 Original study1.6 Original studyScreening C1.610.1016/j.canep.2012.12.002NLMeng D Gobbi201318791879187917Gobbi, P. G.Bergonzi, M.Comelli, M.Villano, L.Pozzoli, D.Vanoli, A.Dionigi, P.Internal Medicine and Gastroenterology, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. gobbipg@smatteo.pv.itThe prognostic role of time to diagnosis and presenting symptoms in patients with pancreatic cancerCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiology186-903722013/02/02Adenocarcinoma/*diagnosis/therapyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/therapyCombined Modality TherapyDelayed DiagnosisFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPalliative CarePancreatic Neoplasms/*diagnosis/therapyPrognosisRetrospective StudiesRisk FactorsSurvival RateWeight Loss2013Apr1877-7821233694501.6 Original study1.6 Original studyScreening C1.610.1016/j.canep.2012.12.002NLMeng=$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
t 0 5 355v5555 55 OpZ yt8MP Wkd $$If l ) I'+*2 3 v O
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l a pZ yt8MP B D McLean201324642464246417McLean, S. R.Karsanji, D.Wilson, J.Dixon, E.Sutherland, F. R.Pasieka, J.Ball, C.Bathe, O. F.Department of Surgery, University of Calgary, Calgary, Alberta, Canada.The effect of wait times on oncological outcomes from periampullary adenocarcinomasJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncology853-810782013/04/30Adenocarcinoma/mortality/pathology/ surgeryAdultAgedAmpulla of Vater/pathology/surgeryCanadaCommon Bile Duct Neoplasms/mortality/pathology/ surgeryFemaleHumansMaleMiddle AgedNeoplasm StagingPancreatectomyPancreatic Neoplasms/mortality/pathology/ surgeryRetrospective StudiesSurvival AnalysisTime FactorsTreatment OutcomeWaiting Lists2013Jun1096-9098 (Electronic)
0022-4790 (Linking)23625192Screening 1.610.1002/jso.23338NLMengB D McLean201324642464246417McLean, S. R.Karsanji, D.Wilson, J.Dixon, E.Sutherland, F. R.Pasieka, J.Ball, C.Bathe, O. F.Department of Surgery, University of Calgary, Calgary, Alberta, Canada.The effect of wait times on oncological outcomes from periampullary adenocarcinomasJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncology853-810782013/04/30Adenocarcinoma/mortality/pathology/ surgeryAdultAgedAmpulla of Vater/pathology/surgeryCanadaCommon Bile Duct Neoplasms/mortality/pathology/ surgeryFemaleHumansMaleMiddle AgedNeoplasm StagingPancreatectomyPancreatic Neoplasms/mortality/pathology/ surgeryRetrospective StudiesSurvival AnalysisTime FactorsTreatment OutcomeWaiting Lists2013Jun1096-9098 (Electronic)
0022-4790 (Linking)23625192Screening 1.610.1002/jso.23338NLMeng=$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
t 0 5 355v5555 55 OpZ yt8MP Wkd $$If l ) I'+*2 3 v O
t 0 $ $ $ $ 4 4
l a pZ yt8MP =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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l a pZ yt8MP D Yun201219241924192417Yun, Y. H.Kim, Y. A.Min, Y. H.Park, S.Won, Y. J.Kim, D. Y.Choi, I. J.Kim, Y. W.Park, S. J.Kim, J. H.Lee, D. H.Yoon, S. J.Jeong, S. Y.Noh, D. Y.Heo, D. S.Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea.The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgeryAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical Oncology2731-723102012/05/04AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasms/*surgeryRegistriesRepublic of KoreaRetrospective Studies*Survival RateWaiting ListsYoung Adult2012Oct0923-7534225531941.6 Original study1.6 Original studyScreening C1.610.1093/annonc/mds101NLMeng D Yun201219241924192417Yun, Y. H.Kim, Y. A.Min, Y. H.Park, S.Won, Y. J.Kim, D. Y.Choi, I. J.Kim, Y. W.Park, S. J.Kim, J. H.Lee, D. H.Yoon, S. J.Jeong, S. Y.Noh, D. Y.Heo, D. S.Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea.The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgeryAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical Oncology2731-723102012/05/04AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasms/*surgeryRegistriesRepublic of KoreaRetrospective Studies*Survival RateWaiting ListsYoung Adult2012Oct0923-7534225531941.6 Original study1.6 Original studyScreening C1.610.1093/annonc/mds101NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
t 0 5 355v5555 55 OpZ yt8MP Wkd $$If l ) I'+*2 3 v O
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l a pZ yt8MP D Glant201124672467246717Glant, J. A.Waters, J. A.House, M. G.Zyromski, N. J.Nakeeb, A.Pitt, H. A.Lillemoe, K. D.Schmidt, C. M.Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA.Does the interval from imaging to operation affect the rate of unanticipated metastasis encountered during operation for pancreatic adenocarcinoma?SurgerySurgerySurgerySurgerySurgerySurgery607-1615042011/10/18AgedCarcinoma, Pancreatic Ductal/diagnosis/pathology/ secondary/ surgeryFalse Negative ReactionsFemaleHumansMagnetic Resonance ImagingMaleNeoplasm Metastasis/diagnosisNeoplasm StagingPancreatic Neoplasms/diagnosis/pathology/ surgeryProspective StudiesTime FactorsTomography, X-Ray Computed2011Oct1532-7361 (Electronic)
0039-6060 (Linking)22000171Screening 1.610.1016/j.surg.2011.07.048NLMeng D Glant201124672467246717Glant, J. A.Waters, J. A.House, M. G.Zyromski, N. J.Nakeeb, A.Pitt, H. A.Lillemoe, K. D.Schmidt, C. M.Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA.Does the interval from imaging to operation affect the rate of unanticipated metastasis encountered during operation for pancreatic adenocarcinoma?SurgerySurgerySurgerySurgerySurgerySurgery607-1615042011/10/18AgedCarcinoma, Pancreatic Ductal/diagnosis/pathology/ secondary/ surgeryFalse Negative ReactionsFemaleHumansMagnetic Resonance ImagingMaleNeoplasm Metastasis/diagnosisNeoplasm StagingPancreatic Neoplasms/diagnosis/pathology/ surgeryProspective StudiesTime FactorsTomography, X-Ray Computed2011Oct1532-7361 (Electronic)
0039-6060 (Linking)22000171Screening 1.610.1016/j.surg.2011.07.048NLMeng =$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
t 0 5 355v5555 55 OpZ yt8MP Wkd * $$If l ) I'+*2 3 v O
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D Eshuis201020072007200717Eshuis, W. J.van der Gaag, N. A.Rauws, E. A.van Eijck, C. H.Bruno, M. J.Kuipers, E. J.Coene, P. P.Kubben, F. J.Gerritsen, J. J.Greve, J. W.Gerhards, M. F.de Hingh, I. H.Klinkenbijl, J. H.Nio, C. Y.de Castro, S. M.Busch, O. R.van Gulik, T. M.Bossuyt, P. M.Gouma, D. J.Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainageAnn SurgAnnals of surgeryAnn SurgAnnals of surgeryAnn SurgAnnals of surgery840-925252010/11/03CholangiographyCholangiopancreatography, Endoscopic RetrogradeDrainage/methodsFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complications/*surgeryPancreaticoduodenectomy/methodsPrognosisProportional Hazards ModelsRisk FactorsStentsSurvival RateTime FactorsTreatment Outcome2010Nov0003-4932210374401.6 Original study1.6 Original studyScreening C1.610.1097/SLA.0b013e3181fd36a2NLMeng
D Eshuis201020072007200717Eshuis, W. J.van der Gaag, N. A.Rauws, E. A.van Eijck, C. H.Bruno, M. J.Kuipers, E. J.Coene, P. P.Kubben, F. J.Gerritsen, J. J.Greve, J. W.Gerhards, M. F.de Hingh, I. H.Klinkenbijl, J. H.Nio, C. Y.de Castro, S. M.Busch, O. R.van Gulik, T. M.Bossuyt, P. M.Gouma, D. J.Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainageAnn SurgAnnals of surgeryAnn SurgAnnals of surgeryAnn SurgAnnals of surgery840-925252010/11/03CholangiographyCholangiopancreatography, Endoscopic RetrogradeDrainage/methodsFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complications/*surgeryPancreaticoduodenectomy/methodsPrognosisProportional Hazards ModelsRisk FactorsStentsSurvival RateTime FactorsTreatment Outcome2010Nov0003-4932210374401.6 Original study1.6 Original studyScreening C1.610.1097/SLA.0b013e3181fd36a2NLMeng Y$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l 4
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l a pZ yt8MP D Raptis201020212021202117Raptis, D. A.Fessas, C.Belasyse-Smith, P.Kurzawinski, T. R.Department of Hepatopancreaticobiliary & Endocrine Surgery, University College London Hospitals, NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. draptis@btinternet.comClinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancerSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland239-46852010/08/17Abdominal Pain/etiologyAgedCarcinoma, Pancreatic Ductal/diagnosis/*mortalityFemaleHumansLondon/epidemiologyMaleMiddle Aged*Outcome Assessment (Health Care)Pancreatic Neoplasms/diagnosis/*mortality/surgeryPrognosisReferral and Consultation/statistics & numerical dataSurvival Analysis*Waiting ListsWeight Loss2010Oct1479-666X (Print)
1479-666x207092791.6 Original study1.6 Original studyScreening C1.610.1016/j.surge.2010.03.001NLMeng D Raptis201020212021202117Raptis, D. A.Fessas, C.Belasyse-Smith, P.Kurzawinski, T. R.Department of Hepatopancreaticobiliary & Endocrine Surgery, University College London Hospitals, NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. draptis@btinternet.comClinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancerSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland239-46852010/08/17Abdominal Pain/etiologyAgedCarcinoma, Pancreatic Ductal/diagnosis/*mortalityFemaleHumansLondon/epidemiologyMaleMiddle Aged*Outcome Assessment (Health Care)Pancreatic Neoplasms/diagnosis/*mortality/surgeryPrognosisReferral and Consultation/statistics & numerical dataSurvival Analysis*Waiting ListsWeight Loss2010Oct1479-666X (Print)
1479-666x207092791.6 Original study1.6 Original studyScreening C1.610.1016/j.surge.2010.03.001NLMeng=$$If !v h#v 3#v#vv#v#v#v#v #v#v O:V l
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yt8MP @ D Jooste201616741674167417Jooste, V.Dejardin, O.Bouvier, V.Arveux, P.Maynadie, M.Launoy, G.Bouvier, A. M.CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Universite Bourgogne Franche-Comte, LNC UMR866, F-21000 Dijon, France.
University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
Breast and Gynaecologic Cancer Registry of Cote D'Or, Centre Georges-Francois Leclerc Comprehensive Cancer Care Centre, Dijon, F-21, France.
Registre Des Hemopathies Malignes De Cote D'Or, EA4184, University of Burgundy, Dijon, F-21, France.Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based studyInt J CancerInternational journal of cancerInt J CancerInternational journal of cancerInt J CancerInternational journal of cancer1073-8013952016/05/01AgedAged, 80 and overComorbidityDelayed DiagnosisFemaleHumansMaleMiddle AgedPancreatic Neoplasms/diagnosis/*epidemiology/mortality/therapyPopulation SurveillanceRisk FactorsSurvival Rate*Time-to-Treatmentcancer registryepidemiologypancreatic cancerpatient delaysurvivaltreatment delay2016Sep 010020-7136271303331.6 Original study1.6 Original studyScreening C1.610.1002/ijc.30166NLMeng @ D Jooste201616741674167417Jooste, V.Dejardin, O.Bouvier, V.Arveux, P.Maynadie, M.Launoy, G.Bouvier, A. M.CHU Dijon Bourgogne, Registre Bourguignon des Cancers Digestifs, F-21000 Dijon, France; INSERM, LNC UMR866, F-21000 Dijon, France; Universite Bourgogne Franche-Comte, LNC UMR866, F-21000 Dijon, France.
University Hospital of Caen, U1086 INSERM UCBN "Cancers & Preventions", Caen, F-14, France.
Breast and Gynaecologic Cancer Registry of Cote D'Or, Centre Georges-Francois Leclerc Comprehensive Cancer Care Centre, Dijon, F-21, France.
Registre Des Hemopathies Malignes De Cote D'Or, EA4184, University of Burgundy, Dijon, F-21, France.Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based studyInt J CancerInternational journal of cancerInt J CancerInternational journal of cancerInt J CancerInternational journal of cancer1073-8013952016/05/01AgedAged, 80 and overComorbidityDelayed DiagnosisFemaleHumansMaleMiddle AgedPancreatic Neoplasms/diagnosis/*epidemiology/mortality/therapyPopulation SurveillanceRisk FactorsSurvival Rate*Time-to-Treatmentcancer registryepidemiologypancreatic cancerpatient delaysurvivaltreatment delay2016Sep 010020-7136271303331.6 Original study1.6 Original studyScreening C1.610.1002/ijc.30166NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP r D Swords201517161716171617Swords, D. S.Mone, M. C.Zhang, C.Presson, A. P.Mulvihill, S. J.Scaife, C. L.Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. douglas.swords@hsc.utah.edu.
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at PresentationJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract1813-2119102015/08/20Abdominal Pain/etiologyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/complications/*pathologyCholecystectomy*Delayed Diagnosis*Diagnostic ErrorsFemaleGallbladder Diseases/diagnosis/surgeryGastroesophageal Reflux/diagnosisHumansJaundice/etiologyMaleMiddle AgedNeoplasm StagingPancreatic Neoplasms/complications/*pathologyPancreatitis/etiologyPeptic Ulcer/diagnosisRetrospective StudiesSurvival RateTime FactorsWeight LossDelay diagnosisMisdiagnosisPancreatic cancerPancreatic ductal adenocarcinomaStage2015Oct1091-255x262863681.6 Original study1.6 Original studyScreening C1.610.1007/s11605-015-2923-zNLMeng r D Swords201517161716171617Swords, D. S.Mone, M. C.Zhang, C.Presson, A. P.Mulvihill, S. J.Scaife, C. L.Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. douglas.swords@hsc.utah.edu.
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.Initial Misdiagnosis of Proximal Pancreatic Adenocarcinoma Is Associated with Delay in Diagnosis and Advanced Stage at PresentationJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary TractJ Gastrointest SurgJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract1813-2119102015/08/20Abdominal Pain/etiologyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/complications/*pathologyCholecystectomy*Delayed Diagnosis*Diagnostic ErrorsFemaleGallbladder Diseases/diagnosis/surgeryGastroesophageal Reflux/diagnosisHumansJaundice/etiologyMaleMiddle AgedNeoplasm StagingPancreatic Neoplasms/complications/*pathologyPancreatitis/etiologyPeptic Ulcer/diagnosisRetrospective StudiesSurvival RateTime FactorsWeight LossDelay diagnosisMisdiagnosisPancreatic cancerPancreatic ductal adenocarcinomaStage2015Oct1091-255x262863681.6 Original study1.6 Original studyScreening C1.610.1007/s11605-015-2923-zNLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP D Gobbi201318791879187917Gobbi, P. G.Bergonzi, M.Comelli, M.Villano, L.Pozzoli, D.Vanoli, A.Dionigi, P.Internal Medicine and Gastroenterology, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. gobbipg@smatteo.pv.itThe prognostic role of time to diagnosis and presenting symptoms in patients with pancreatic cancerCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiology186-903722013/02/02Adenocarcinoma/*diagnosis/therapyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/therapyCombined Modality TherapyDelayed DiagnosisFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPalliative CarePancreatic Neoplasms/*diagnosis/therapyPrognosisRetrospective StudiesRisk FactorsSurvival RateWeight Loss2013Apr1877-7821233694501.6 Original study1.6 Original studyScreening C1.610.1016/j.canep.2012.12.002NLMeng D Gobbi201318791879187917Gobbi, P. G.Bergonzi, M.Comelli, M.Villano, L.Pozzoli, D.Vanoli, A.Dionigi, P.Internal Medicine and Gastroenterology, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. gobbipg@smatteo.pv.itThe prognostic role of time to diagnosis and presenting symptoms in patients with pancreatic cancerCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiologyCancer EpidemiolCancer epidemiology186-903722013/02/02Adenocarcinoma/*diagnosis/therapyAdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/therapyCombined Modality TherapyDelayed DiagnosisFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPalliative CarePancreatic Neoplasms/*diagnosis/therapyPrognosisRetrospective StudiesRisk FactorsSurvival RateWeight Loss2013Apr1877-7821233694501.6 Original study1.6 Original studyScreening C1.610.1016/j.canep.2012.12.002NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP D Raptis201020212021202117Raptis, D. A.Fessas, C.Belasyse-Smith, P.Kurzawinski, T. R.Department of Hepatopancreaticobiliary & Endocrine Surgery, University College London Hospitals, NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. draptis@btinternet.comClinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancerSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland239-46852010/08/17Abdominal Pain/etiologyAgedCarcinoma, Pancreatic Ductal/diagnosis/*mortalityFemaleHumansLondon/epidemiologyMaleMiddle Aged*Outcome Assessment (Health Care)Pancreatic Neoplasms/diagnosis/*mortality/surgeryPrognosisReferral and Consultation/statistics & numerical dataSurvival Analysis*Waiting ListsWeight Loss2010Oct1479-666X (Print)
1479-666x207092791.6 Original study1.6 Original studyScreening C1.610.1016/j.surge.2010.03.001NLMeng D Raptis201020212021202117Raptis, D. A.Fessas, C.Belasyse-Smith, P.Kurzawinski, T. R.Department of Hepatopancreaticobiliary & Endocrine Surgery, University College London Hospitals, NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK. draptis@btinternet.comClinical presentation and waiting time targets do not affect prognosis in patients with pancreatic cancerSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and IrelandSurgeonThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland239-46852010/08/17Abdominal Pain/etiologyAgedCarcinoma, Pancreatic Ductal/diagnosis/*mortalityFemaleHumansLondon/epidemiologyMaleMiddle Aged*Outcome Assessment (Health Care)Pancreatic Neoplasms/diagnosis/*mortality/surgeryPrognosisReferral and Consultation/statistics & numerical dataSurvival Analysis*Waiting ListsWeight Loss2010Oct1479-666X (Print)
1479-666x207092791.6 Original study1.6 Original studyScreening C1.610.1016/j.surge.2010.03.001NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v 2:V l
t 0 65 2p
yt8MP $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v 2:V l
t 0 65 2p
yt8MP f D Healy201824742474247417Healy, G. M.Redmond, C. E.Murphy, S.Fleming, H.Haughey, A.Kavanagh, R.Swan, N.Conlon, K. C.Malone, D. E.Ryan, E. R.Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. ger.healy@svuh.ie.
Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Histopathology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Pancreatic Surgery, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.Preoperative CT in patients with surgically resectable pancreatic adenocarcinoma: does the time interval between CT and surgery affect survival?Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)620-6284332017/07/122018Mar2366-0058 (Electronic)28695235Screening C1.610.1007/s00261-017-1254-9NLMeng f D Healy201824742474247417Healy, G. M.Redmond, C. E.Murphy, S.Fleming, H.Haughey, A.Kavanagh, R.Swan, N.Conlon, K. C.Malone, D. E.Ryan, E. R.Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. ger.healy@svuh.ie.
Department of Radiology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Histopathology, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Pancreatic Surgery, National Surgical Centre for Pancreatic Cancer, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.Preoperative CT in patients with surgically resectable pancreatic adenocarcinoma: does the time interval between CT and surgery affect survival?Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)Abdom Radiol (NY)Abdominal radiology (New York)620-6284332017/07/122018Mar2366-0058 (Electronic)28695235Screening C1.610.1007/s00261-017-1254-9NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP D Amr201616781678167817Amr, B.Shahtahmassebi, G.Briggs, C. D.Bowles, M. J.Aroori, S.Stell, D. A.Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK. Electronic address: B.amr@nhs.net.
School of Science and Technology, Nottingham Trent University, Nottingham, NG1 4BU, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK.Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancyHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary Association354-91842016/04/03Adenocarcinoma/mortality/pathology/*surgeryAdultAgedAged, 80 and overAmpulla of Vater/pathology/*surgeryBile Duct Neoplasms/mortality/pathology/*surgeryChi-Square DistributionDatabases, FactualDuodenal Neoplasms/mortality/pathology/*surgeryFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm, ResidualOdds RatioPancreatic Neoplasms/mortality/pathology/*surgeryProportional Hazards ModelsRisk FactorsTime Factors*Time-to-TreatmentTreatment Outcome2016Apr1365-182x270372051.6 Original studyPMC48146111.6 Original studyScreening C1.610.1016/j.hpb.2015.10.013NLMeng D Amr201616781678167817Amr, B.Shahtahmassebi, G.Briggs, C. D.Bowles, M. J.Aroori, S.Stell, D. A.Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK. Electronic address: B.amr@nhs.net.
School of Science and Technology, Nottingham Trent University, Nottingham, NG1 4BU, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK.
Peninsula HPB Unit, Derriford Hospital, Plymouth, PL6 8DH, UK; Peninsula Schools of Medicine and Dentistry, Plymouth University, PL6 8BU, UK.Assessment of the effect of interval from presentation to surgery on outcome in patients with peri-ampullary malignancyHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary AssociationHPB (Oxford)HPB : the official journal of the International Hepato Pancreato Biliary Association354-91842016/04/03Adenocarcinoma/mortality/pathology/*surgeryAdultAgedAged, 80 and overAmpulla of Vater/pathology/*surgeryBile Duct Neoplasms/mortality/pathology/*surgeryChi-Square DistributionDatabases, FactualDuodenal Neoplasms/mortality/pathology/*surgeryFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm, ResidualOdds RatioPancreatic Neoplasms/mortality/pathology/*surgeryProportional Hazards ModelsRisk FactorsTime Factors*Time-to-TreatmentTreatment Outcome2016Apr1365-182x270372051.6 Original studyPMC48146111.6 Original studyScreening C1.610.1016/j.hpb.2015.10.013NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP \
D Sanjeevi201617021702170217Sanjeevi, S.Ivanics, T.Lundell, L.Kartalis, N.Andren-Sandberg, A.Blomberg, J.Del Chiaro, M.Ansorge, C.Department of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Division of Surgery, Karolinska Institute, Stockholm, Sweden.
Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.Impact of delay between imaging and treatment in patients with potentially curable pancreatic cancerBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgery267-7510332015/11/18AdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/surgeryDiagnostic Imaging/*methodsDisease ProgressionFemaleFollow-Up StudiesHumansLaparotomyMaleMiddle AgedPancreatectomy/*methodsPancreatic Neoplasms/*diagnosis/surgeryPrognosisRetrospective StudiesTime Factors2016Feb0007-1323265725091.6 Original study1.6 Original studyScreening C1.610.1002/bjs.10046NLMeng \
D Sanjeevi201617021702170217Sanjeevi, S.Ivanics, T.Lundell, L.Kartalis, N.Andren-Sandberg, A.Blomberg, J.Del Chiaro, M.Ansorge, C.Department of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Division of Surgery, Karolinska Institute, Stockholm, Sweden.
Division of Radiology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.Impact of delay between imaging and treatment in patients with potentially curable pancreatic cancerBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgeryBr J SurgThe British journal of surgery267-7510332015/11/18AdultAgedAged, 80 and overCarcinoma, Pancreatic Ductal/*diagnosis/surgeryDiagnostic Imaging/*methodsDisease ProgressionFemaleFollow-Up StudiesHumansLaparotomyMaleMiddle AgedPancreatectomy/*methodsPancreatic Neoplasms/*diagnosis/surgeryPrognosisRetrospective StudiesTime Factors2016Feb0007-1323265725091.6 Original study1.6 Original studyScreening C1.610.1002/bjs.10046NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP
D Driedger201517371737173717Driedger, M. R.Dixon, E.Mohamed, R.Sutherland, F. R.Bathe, O. F.Ball, C. G.Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: ball.chad@gmail.com.The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?J Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical research39-4319912015/05/09Adenocarcinoma/*diagnosis/surgeryAdultAgedAged, 80 and overAlbertaDelayed Diagnosis/*statistics & numerical dataFemaleHumansMaleMiddle AgedPancreatic Neoplasms/*diagnosis/surgeryPractice Patterns, Physicians'/*statistics & numerical dataReferral and Consultation/*statistics & numerical dataRetrospective StudiesTomography, X-Ray Computed/statistics & numerical data/utilizationUnnecessary Procedures/statistics & numerical data/*utilizationPancreatic cancerUnnecessary testing2015Nov0022-4804259532171.6 Original study1.6 Original studyScreening C1.610.1016/j.jss.2015.04.026NLMeng
D Driedger201517371737173717Driedger, M. R.Dixon, E.Mohamed, R.Sutherland, F. R.Bathe, O. F.Ball, C. G.Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada. Electronic address: ball.chad@gmail.com.The diagnostic pathway for solid pancreatic neoplasms: are we applying too many tests?J Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical researchJ Surg ResThe Journal of surgical research39-4319912015/05/09Adenocarcinoma/*diagnosis/surgeryAdultAgedAged, 80 and overAlbertaDelayed Diagnosis/*statistics & numerical dataFemaleHumansMaleMiddle AgedPancreatic Neoplasms/*diagnosis/surgeryPractice Patterns, Physicians'/*statistics & numerical dataReferral and Consultation/*statistics & numerical dataRetrospective StudiesTomography, X-Ray Computed/statistics & numerical data/utilizationUnnecessary Procedures/statistics & numerical data/*utilizationPancreatic cancerUnnecessary testing2015Nov0022-4804259532171.6 Original study1.6 Original studyScreening C1.610.1016/j.jss.2015.04.026NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP
D Raman201524732473247317Raman, S. P.Reddy, S.Weiss, M. J.Manos, L. L.Cameron, J. L.Zheng, L.Herman, J. M.Hruban, R. H.Fishman, E. K.Wolfgang, C. L.1 Department of Radiology, Johns Hopkins University School of Medicine, JHOC 3251, 601 N Caroline St, Baltimore, MD 21287.Impact of the time interval between MDCT imaging and surgery on the accuracy of identifying metastatic disease in patients with pancreatic cancerAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyW37-4220412014/12/30Adenoma/ diagnostic imaging/surgeryAdultAgedEarly DiagnosisFemaleHumansImage Enhancement/ methodsLymphatic MetastasisMaleMiddle AgedMultidetector Computed Tomography/ methodsPancreatic Neoplasms/ diagnostic imaging/secondary/surgeryReproducibility of ResultsSensitivity and SpecificityTime Factors2015Jan1546-3141 (Electronic)
0361-803X (Linking)25539271PMC4872713Screening 1.6Nihms78540710.2214/ajr.13.12439NLMeng
D Raman201524732473247317Raman, S. P.Reddy, S.Weiss, M. J.Manos, L. L.Cameron, J. L.Zheng, L.Herman, J. M.Hruban, R. H.Fishman, E. K.Wolfgang, C. L.1 Department of Radiology, Johns Hopkins University School of Medicine, JHOC 3251, 601 N Caroline St, Baltimore, MD 21287.Impact of the time interval between MDCT imaging and surgery on the accuracy of identifying metastatic disease in patients with pancreatic cancerAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyAJR Am J RoentgenolAJR. American journal of roentgenologyW37-4220412014/12/30Adenoma/ diagnostic imaging/surgeryAdultAgedEarly DiagnosisFemaleHumansImage Enhancement/ methodsLymphatic MetastasisMaleMiddle AgedMultidetector Computed Tomography/ methodsPancreatic Neoplasms/ diagnostic imaging/secondary/surgeryReproducibility of ResultsSensitivity and SpecificityTime Factors2015Jan1546-3141 (Electronic)
0361-803X (Linking)25539271PMC4872713Screening 1.6Nihms78540710.2214/ajr.13.12439NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP B D McLean201324642464246417McLean, S. R.Karsanji, D.Wilson, J.Dixon, E.Sutherland, F. R.Pasieka, J.Ball, C.Bathe, O. F.Department of Surgery, University of Calgary, Calgary, Alberta, Canada.The effect of wait times on oncological outcomes from periampullary adenocarcinomasJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncology853-810782013/04/30Adenocarcinoma/mortality/pathology/ surgeryAdultAgedAmpulla of Vater/pathology/surgeryCanadaCommon Bile Duct Neoplasms/mortality/pathology/ surgeryFemaleHumansMaleMiddle AgedNeoplasm StagingPancreatectomyPancreatic Neoplasms/mortality/pathology/ surgeryRetrospective StudiesSurvival AnalysisTime FactorsTreatment OutcomeWaiting Lists2013Jun1096-9098 (Electronic)
0022-4790 (Linking)23625192Screening 1.610.1002/jso.23338NLMengB D McLean201324642464246417McLean, S. R.Karsanji, D.Wilson, J.Dixon, E.Sutherland, F. R.Pasieka, J.Ball, C.Bathe, O. F.Department of Surgery, University of Calgary, Calgary, Alberta, Canada.The effect of wait times on oncological outcomes from periampullary adenocarcinomasJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncologyJ Surg OncolJournal of surgical oncology853-810782013/04/30Adenocarcinoma/mortality/pathology/ surgeryAdultAgedAmpulla of Vater/pathology/surgeryCanadaCommon Bile Duct Neoplasms/mortality/pathology/ surgeryFemaleHumansMaleMiddle AgedNeoplasm StagingPancreatectomyPancreatic Neoplasms/mortality/pathology/ surgeryRetrospective StudiesSurvival AnalysisTime FactorsTreatment OutcomeWaiting Lists2013Jun1096-9098 (Electronic)
0022-4790 (Linking)23625192Screening 1.610.1002/jso.23338NLMeng $$If !v h#v z#v ,:V l
t 0 65 z5 ,p yt8MP D Glant201124672467246717Glant, J. A.Waters, J. A.House, M. G.Zyromski, N. J.Nakeeb, A.Pitt, H. A.Lillemoe, K. D.Schmidt, C. M.Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA.Does the interval from imaging to operation affect the rate of unanticipated metastasis encountered during operation for pancreatic adenocarcinoma?SurgerySurgerySurgerySurgerySurgerySurgery607-1615042011/10/18AgedCarcinoma, Pancreatic Ductal/diagnosis/pathology/ secondary/ surgeryFalse Negative ReactionsFemaleHumansMagnetic Resonance ImagingMaleNeoplasm Metastasis/diagnosisNeoplasm StagingPancreatic Neoplasms/diagnosis/pathology/ surgeryProspective StudiesTime FactorsTomography, X-Ray Computed2011Oct1532-7361 (Electronic)
0039-6060 (Linking)22000171Screening 1.610.1016/j.surg.2011.07.048NLMeng D Glant201124672467246717Glant, J. A.Waters, J. A.House, M. G.Zyromski, N. J.Nakeeb, A.Pitt, H. A.Lillemoe, K. D.Schmidt, C. M.Indiana University School of Medicine, Department of Surgery, Indianapolis, IN, USA.Does the interval from imaging to operation affect the rate of unanticipated metastasis encountered during operation for pancreatic adenocarcinoma?SurgerySurgerySurgerySurgerySurgerySurgery607-1615042011/10/18AgedCarcinoma, Pancreatic Ductal/diagnosis/pathology/ secondary/ surgeryFalse Negative ReactionsFemaleHumansMagnetic Resonance ImagingMaleNeoplasm Metastasis/diagnosisNeoplasm StagingPancreatic Neoplasms/diagnosis/pathology/ surgeryProspective StudiesTime FactorsTomography, X-Ray Computed2011Oct1532-7361 (Electronic)
0039-6060 (Linking)22000171Screening 1.610.1016/j.surg.2011.07.048NLMeng $$If !v h#v z#v ,:V l
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D Eshuis201020072007200717Eshuis, W. J.van der Gaag, N. A.Rauws, E. A.van Eijck, C. H.Bruno, M. J.Kuipers, E. J.Coene, P. P.Kubben, F. J.Gerritsen, J. J.Greve, J. W.Gerhards, M. F.de Hingh, I. H.Klinkenbijl, J. H.Nio, C. Y.de Castro, S. M.Busch, O. R.van Gulik, T. M.Bossuyt, P. M.Gouma, D. J.Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainageAnn SurgAnnals of surgeryAnn SurgAnnals of surgeryAnn SurgAnnals of surgery840-925252010/11/03CholangiographyCholangiopancreatography, Endoscopic RetrogradeDrainage/methodsFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complications/*surgeryPancreaticoduodenectomy/methodsPrognosisProportional Hazards ModelsRisk FactorsStentsSurvival RateTime FactorsTreatment Outcome2010Nov0003-4932210374401.6 Original study1.6 Original studyScreening C1.610.1097/SLA.0b013e3181fd36a2NLMeng
D Eshuis201020072007200717Eshuis, W. J.van der Gaag, N. A.Rauws, E. A.van Eijck, C. H.Bruno, M. J.Kuipers, E. J.Coene, P. P.Kubben, F. J.Gerritsen, J. J.Greve, J. W.Gerhards, M. F.de Hingh, I. H.Klinkenbijl, J. H.Nio, C. Y.de Castro, S. M.Busch, O. R.van Gulik, T. M.Bossuyt, P. M.Gouma, D. J.Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands.Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainageAnn SurgAnnals of surgeryAnn SurgAnnals of surgeryAnn SurgAnnals of surgery840-925252010/11/03CholangiographyCholangiopancreatography, Endoscopic RetrogradeDrainage/methodsFemaleHumansJaundice, Obstructive/*etiology/*therapyMaleMiddle AgedPancreatic Neoplasms/*complications/*surgeryPancreaticoduodenectomy/methodsPrognosisProportional Hazards ModelsRisk FactorsStentsSurvival RateTime FactorsTreatment Outcome2010Nov0003-4932210374401.6 Original study1.6 Original studyScreening C1.610.1097/SLA.0b013e3181fd36a2NLMeng $$If !v h#v z#v ,:V l
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yt8MP D Yun201219241924192417Yun, Y. H.Kim, Y. A.Min, Y. H.Park, S.Won, Y. J.Kim, D. Y.Choi, I. J.Kim, Y. W.Park, S. J.Kim, J. H.Lee, D. H.Yoon, S. J.Jeong, S. Y.Noh, D. Y.Heo, D. S.Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea.The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgeryAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical Oncology2731-723102012/05/04AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasms/*surgeryRegistriesRepublic of KoreaRetrospective Studies*Survival RateWaiting ListsYoung Adult2012Oct0923-7534225531941.6 Original study1.6 Original studyScreening C1.610.1093/annonc/mds101NLMeng D Yun201219241924192417Yun, Y. H.Kim, Y. A.Min, Y. H.Park, S.Won, Y. J.Kim, D. Y.Choi, I. J.Kim, Y. W.Park, S. J.Kim, J. H.Lee, D. H.Yoon, S. J.Jeong, S. Y.Noh, D. Y.Heo, D. S.Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul, Korea.The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgeryAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical OncologyAnn OncolAnnals of oncology : official journal of the European Society for Medical Oncology2731-723102012/05/04AdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNeoplasms/*surgeryRegistriesRepublic of KoreaRetrospective Studies*Survival RateWaiting ListsYoung Adult2012Oct0923-7534225531941.6 Original study1.6 Original studyScreening C1.610.1093/annonc/mds101NLMeng $$If !v h#v z#v ,:V l
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