Aspects of The Preoperative Pathway in Pancreatic Head Malignancy
MetadataShow full item record
Malignancy within the pancreatic head can arise from pancreatic duct, distal bile duct, ampulla or duodenum. Since September 2000, surgery for all pancreatic head malignancy (PHM) has been centralised into regional pancreatic centres where assessment of preoperative imaging and subsequent surgery is undertaken. As part of this guidance, surgery must be performed within 62-days of referral. This project will assess four aspects of the pre-operative pathway in PHM: 1) Potential variation in outcome of patients referred from different sites within a Cancer Network 2) Potential variation in outcome associated with different intervals to surgery within the 62 day guideline 3) The ability of interpretation of heterogeneous pre-operative CT scans from different hospitals to determine the resectability of PHM 4) The ability of CT scan to distinguish the different tumour types of PHM Images of a consecutive series of patients were re-reported and compared with final pathology reports. Good agreement was noted in determining the tumour origin of PHM (observed agreement = 0.758, Kappa= 0.6 (0.51-0.68)). In the assessment surgical outcomes, geographical isolation from the regional centre was not associated with delay to surgery. Variation in outcome between referral centres was however noted but this was not associated with travel distance. Although little association was noted between delay to surgery and outcome overall, a paradoxical improvement in survival was noted however for the small group of patients with ampullary tumours who waited longer than the median interval to surgery.
Showing items related by title, author, creator and subject.
Counsellee’s experience of cancer genetic counselling with pedigrees that automatically incorporate genealogical and cancer database information Stefansdottir, V; Johannsson, OT; Skirton, H; Jonsson, JJ (2016-07-02)
Mixed method systematic review: The relationship between breast cancer risk perception and health-protective behaviour in women with family history of breast cancer. Paalosalo-Harris, K; Skirton, H (2016-09-21)To determine and explore the relationship between risk perception and health-protective behaviour in individuals with family history of breast cancer.Women with increased risk of breast cancer due to inherited predisposition ...