caa a22 4500 445338393 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1282-y doi (NATIONALLICENCE)springer-10.1245/s10434-010-1282-y Standardization of Surgical and Pathologic Variables is Needed in Multicenter Trials of Adjuvant Therapy for Pancreatic Cancer: Results from the ACOSOG Z5031 Trial [Elektronische Daten] [Matthew Katz, Nipun Merchant, Steven Brower, Megan Branda, Mitchell Posner, L. William Traverso, Ross Abrams, Vincent Picozzi, Peter Pisters] Background: Standardization of surgical and pathologic techniques is crucial to the interpretation of studies evaluating adjuvant therapies for pancreatic cancer (PC). Methods: To assess the degree to which treatment administered prior to enrollment of patients in trials of adjuvant therapy is quality controlled, the operative and pathology reports of patients in American College of Surgeons Oncology Group (ACOSOG) Z5031—a national trial of chemoradiation following pancreaticoduodenectomy (PD)—were rigorously evaluated. We analyzed variables with the potential to influence staging or outcome. Results: 80 patients reported to have undergone R0 (75%) or R1 (25%) pylorus-preserving (38%) or standard (62%) PD were evaluated. A search for metastases was documented in 96% of cases. The proximity of the tumor to the superior mesenteric vein was reported in 69%; vein resection was required in 9% and lateral venorrhaphy in 14%. The method of dissection along the superior mesenteric artery (SMA) was described in 68%, being ultrasonic dissection (17%), stapler (24%), and clamp and cut (59%). SMA skeletonization was described in 25%, and absence of disease following resection was documented in 24%. The surgeon reported marking the critical SMA margin in 25%; inking was documented in 65% of cases and evaluation of the SMA margin was reported in 47%. A range of 1-49 lymph nodes was evaluated. Only 34% of pathology reports met College of American Pathologists criteria. Conclusions: Trials of adjuvant therapy following PD suffer from a lack of standardization and quality control prior to patient enrollment. These data suggest areas for improvement in the design of multidisciplinary treatment protocols. Society of Surgical Oncology, 2010 Katz Matthew Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Merchant Nipun Division of Surgical Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA aut Brower Steven Department of Surgery, Anderson Cancer Institute, Memorial University Medical Center, Savannah, GA, USA aut Branda Megan Division of Health Sciences Research, The Mayo Clinic, Rochester, MN, USA aut Posner Mitchell Division of Surgical Oncology, The University of Chicago Medical Center, Chicago, IL, USA aut William Traverso L. Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA aut Abrams Ross Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA aut Picozzi Vincent Department of Medical Oncology, Virginia Mason Medical Center, Seattle, WA, USA aut Pisters Peter Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 337-344 1068-9265 18:2<337 2011 18 10434 https://doi.org/10.1245/s10434-010-1282-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1282-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Katz Matthew Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Merchant Nipun Division of Surgical Oncology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA aut NATIONALLICENCE 700 1- Brower Steven Department of Surgery, Anderson Cancer Institute, Memorial University Medical Center, Savannah, GA, USA aut NATIONALLICENCE 700 1- Branda Megan Division of Health Sciences Research, The Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Posner Mitchell Division of Surgical Oncology, The University of Chicago Medical Center, Chicago, IL, USA aut NATIONALLICENCE 700 1- William Traverso L. Department of Surgery, Virginia Mason Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Abrams Ross Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA aut NATIONALLICENCE 700 1- Picozzi Vincent Department of Medical Oncology, Virginia Mason Medical Center, Seattle, WA, USA aut NATIONALLICENCE 700 1- Pisters Peter Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 337-344 1068-9265 18:2<337 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer