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Perspectives of the medical oncologist regarding adjuvant chemotherapy for pancreatic cancer: An international expert survey and case vignette study

Biesma, N. C.
; 
Graus, M.
; 
Cirkel, G. A.
; 
Besselink, M. G.
; 
de Groot, J. W. B.
; 
Koerkamp, B. G.
; 
Herbschleb, K. H.
; 
Los, M.
; 
Verdonk, R. C.
; 
Wilmink, J. W.
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Abstract
INTRODUCTION: Adjuvant chemotherapy improves survival in patients with resected pancreatic ductal adenocarcinoma (PDAC). The decision to initiate chemotherapy involves both patient and physician factors, decision-specific criteria, and contextual considerations. This study aimed to assess medical oncologists' views on adjuvant chemotherapy following pancreatic resection for PDAC. METHODS: An online survey and case vignette study were distributed to medical oncologists via the Dutch Pancreatic Cancer Group (DPCG), International Hepato-Pancreato-Biliary Association (IHPBA) and related networks. RESULTS: A total of 91 oncologists from 14 countries participated, 46 % of whom treated more than 40 new PDAC patients annually, with a median experience of 15 years. Significant discrepancies were noted in their recommendations for adjuvant chemotherapy across case vignettes. In patients over 70, 17 % advised against chemotherapy, while 31 % said age was not a factor. Oncologists with less than 10 years of experience and those in non-academic settings were less likely to recommend adjuvant therapy. While 87 % agreed mFOLFIRINOX is the preferred adjuvant treatment, consensus on individual cases was lacking. The recommended interval between surgery and chemotherapy ranged from 3 to 26 weeks, with varying reasons for withholding treatment, primarily due to postoperative recovery and performance status. CONCLUSIONS: Our study revealed substantial variation among oncologists in counseling on adjuvant chemotherapy after PDAC resection. This emphasizes the need for more patient involvement in decision-making and improving shared decision-making.
Authors
Biesma, N. C.
Graus, M.
Cirkel, G. A.
Besselink, M. G.
de Groot, J. W. B.
Koerkamp, B. G.
Herbschleb, K. H.
Los, M.
Verdonk, R. C.
Wilmink, J. W.
Cervantes, A.
Valle, J. W.
Valkenburg-van Iersel, L. B. J.
Froeling, F. E. M.
Molenaar, I. Q.
Daamen, L. A.
de Vos-Geelen, J.
van Santvoort, H. C.
Affiliation
University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Surgery, the Netherlands. Electronic address: n.c.biesma-2@umcutrecht.nl. Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Research Institute for Oncology & Reproduction, Maastricht, the Netherlands. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein & Meander Medical Center Amersfoort, Regional Academic Cancer Center Utrecht, Department of Medical Oncology, the Netherlands. Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands. Isala Oncology Center, Department of Medical Oncology, Zwolle, the Netherlands. Erasmus Medical Center, Department of Surgery, Rotterdam, the Netherlands. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Medical Oncology, the Netherlands. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Gastroenterology and Hepatology, the Netherlands. Cancer Center Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Department of Medical Oncology, Amsterdam, the Netherlands. Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Spain. Cholangiocarcinoma Foundation, Herriman, Utah, USA; Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom. Dept. of Medical Oncology, Clinical Senior Lecturer and Honorary Consultant Medical Oncologist, University of Glasgow and Beatson West of Scotland Cancer Centre, United Kingdom. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Surgery, the Netherlands. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Surgery, the Netherlands; University Medical Center Utrecht Cancer Center, Division of Imaging & Oncology, Utrecht, the Netherlands. University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Regional Academic Cancer Center Utrecht, Department of Surgery, the Netherlands. Electronic address: h.van.santvoort@antoniusziekenhuis.nl.
Description
Date
2025
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All Paterson Institute for Cancer Research
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Article
Citation
Biesma NC, Graus M, Cirkel GA, Besselink MG, de Groot JWB, Koerkamp BG, et al. Perspectives of the medical oncologist regarding adjuvant chemotherapy for pancreatic cancer: An international expert survey and case vignette study. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2025 Mar;51(3):109544. PubMed PMID: 39689462. Epub 2024/12/18. eng.
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https://christie.openrepository.com/handle/10541/627979
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