Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol

Abstract Introduction Patients with pancreatic ductal adenocarcinoma (PDAC) have a dismal prognosis. The majority of patients are diagnosed at an advanced stage, and for these patients, the only possible treatment is palliative chemotherapy. There are increasing data from retrospective studies indic...

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Main Authors: Kristina Hasselgren, Caroline Williamsson, Johanna Wennerblom, Poya Ghorbani, Maria Gustafsson Liljefors, Heikki Huhta, Margareta Heby, Christopher Månsson, Mia I. Johansson, Nils O. Elander, Minna Nortunen, Raija Kallio, Asif Halimi, Daniel Öhlund, Per Sandström, Ernesto Sparrelid, Bergthor Björnsson
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02983-w
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author Kristina Hasselgren
Caroline Williamsson
Johanna Wennerblom
Poya Ghorbani
Maria Gustafsson Liljefors
Heikki Huhta
Margareta Heby
Christopher Månsson
Mia I. Johansson
Nils O. Elander
Minna Nortunen
Raija Kallio
Asif Halimi
Daniel Öhlund
Per Sandström
Ernesto Sparrelid
Bergthor Björnsson
author_facet Kristina Hasselgren
Caroline Williamsson
Johanna Wennerblom
Poya Ghorbani
Maria Gustafsson Liljefors
Heikki Huhta
Margareta Heby
Christopher Månsson
Mia I. Johansson
Nils O. Elander
Minna Nortunen
Raija Kallio
Asif Halimi
Daniel Öhlund
Per Sandström
Ernesto Sparrelid
Bergthor Björnsson
author_sort Kristina Hasselgren
collection DOAJ
description Abstract Introduction Patients with pancreatic ductal adenocarcinoma (PDAC) have a dismal prognosis. The majority of patients are diagnosed at an advanced stage, and for these patients, the only possible treatment is palliative chemotherapy. There are increasing data from retrospective studies indicating that a subgroup of patients with liver-limited metastases may benefit from surgical treatment of liver metastases. However, there is a need for prospective trials. Objective The aim of this study is to prospectively investigate the safety and feasibility of surgically treating patients who are resectable, including those with borderline venous resectable, histopathologically confirmed PDAC, and histopathologically or radiologically confirmed liver metastases. Methods Five Swedish and one Finnish hepatopancreaticobiliary (HPB) centre will participate. Eligible patients will be identified at regional multidisciplinary conferences (MDTs). Before inclusion, they will undergo computed tomography (CT), magnetic resonance imaging (MRI, ) and (positron emission tomography computed tomography)PET-CT to rule out extrahepatic metastases. To be included, patients will have to have four or fewer liver metastases, which must be no larger than 5 cm for patients planning for resection and no larger than 2 cm for patients planning for ablation. The metastases may be either synchronous or metachronous. Patients will undergo four months of chemotherapy before surgical treatment (either resection or ablation), and postoperatively, they will undergo two months of chemotherapy. For those with synchronous metastases, resection of the pancreatic tumour will be performed. Follow-up will be performed over two years postoperatively with regular CT scans and assessments of quality of life. Conclusions In conclusion, this trial will provide increased knowledge concerning whether surgical treatment of liver metastases from pancreatic cancer can result in improved survival. Clinical Trial Number Clinical.Trials.gov (NCT05271110), registered February 26th 2022
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spelling doaj-art-0059c18a7608410e9f0064767a2fc88d2025-08-20T04:01:42ZengBMCBMC Surgery1471-24822025-07-012511710.1186/s12893-025-02983-wProspective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocolKristina Hasselgren0Caroline Williamsson1Johanna Wennerblom2Poya Ghorbani3Maria Gustafsson Liljefors4Heikki Huhta5Margareta Heby6Christopher Månsson7Mia I. Johansson8Nils O. Elander9Minna Nortunen10Raija Kallio11Asif Halimi12Daniel Öhlund13Per Sandström14Ernesto Sparrelid15Bergthor Björnsson16Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping UniversityDepartment of Surgery, Clinical Sciences Lund, Lund University and Skåne University HospitalDepartment of Surgery, The Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalSurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of OuluDepartment of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Skåne University HospitalDepartment of Surgical Sciences, Uppsala UniversityDepartment of oncology, The Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Oncology, Department of Biomedical and Clinical Sciences, Linköping UniversitySurgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of OuluDepartment of Oncology and Haematology, Oulu University Hospital, University of OuluDepartment of Diagnostics and Intervention, Surgery, Umeå UniversityDepartment of Diagnostics and Intervention and Wallenberg Centre for Molecular Medicine, Umeå University (WCMM)Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping UniversityDivision of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University HospitalDepartment of Surgery, Linköping University HospitalAbstract Introduction Patients with pancreatic ductal adenocarcinoma (PDAC) have a dismal prognosis. The majority of patients are diagnosed at an advanced stage, and for these patients, the only possible treatment is palliative chemotherapy. There are increasing data from retrospective studies indicating that a subgroup of patients with liver-limited metastases may benefit from surgical treatment of liver metastases. However, there is a need for prospective trials. Objective The aim of this study is to prospectively investigate the safety and feasibility of surgically treating patients who are resectable, including those with borderline venous resectable, histopathologically confirmed PDAC, and histopathologically or radiologically confirmed liver metastases. Methods Five Swedish and one Finnish hepatopancreaticobiliary (HPB) centre will participate. Eligible patients will be identified at regional multidisciplinary conferences (MDTs). Before inclusion, they will undergo computed tomography (CT), magnetic resonance imaging (MRI, ) and (positron emission tomography computed tomography)PET-CT to rule out extrahepatic metastases. To be included, patients will have to have four or fewer liver metastases, which must be no larger than 5 cm for patients planning for resection and no larger than 2 cm for patients planning for ablation. The metastases may be either synchronous or metachronous. Patients will undergo four months of chemotherapy before surgical treatment (either resection or ablation), and postoperatively, they will undergo two months of chemotherapy. For those with synchronous metastases, resection of the pancreatic tumour will be performed. Follow-up will be performed over two years postoperatively with regular CT scans and assessments of quality of life. Conclusions In conclusion, this trial will provide increased knowledge concerning whether surgical treatment of liver metastases from pancreatic cancer can result in improved survival. Clinical Trial Number Clinical.Trials.gov (NCT05271110), registered February 26th 2022https://doi.org/10.1186/s12893-025-02983-wPancreatic cancerLiver metastasesResectionAblation
spellingShingle Kristina Hasselgren
Caroline Williamsson
Johanna Wennerblom
Poya Ghorbani
Maria Gustafsson Liljefors
Heikki Huhta
Margareta Heby
Christopher Månsson
Mia I. Johansson
Nils O. Elander
Minna Nortunen
Raija Kallio
Asif Halimi
Daniel Öhlund
Per Sandström
Ernesto Sparrelid
Bergthor Björnsson
Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
BMC Surgery
Pancreatic cancer
Liver metastases
Resection
Ablation
title Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
title_full Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
title_fullStr Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
title_full_unstemmed Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
title_short Prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer - ScanPan study protocol
title_sort prospective evaluation of surgical treatment of liver metastasizing pancreatic cancer scanpan study protocol
topic Pancreatic cancer
Liver metastases
Resection
Ablation
url https://doi.org/10.1186/s12893-025-02983-w
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