. 2025 Jul 19;25(1):299.

doi: 10.1186/s12893-025-02983-w.

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

Kristina Hasselgren¹, Caroline Williamsson², Johanna Wennerblom³, Poya Ghorbani⁴, Maria Gustafsson Liljefors⁴, Heikki Huhta⁵, Margareta Heby⁶, Christopher Månsson⁷, Mia I Johansson⁸, Nils O Elander⁹, Minna Nortunen⁵, Raija Kallio¹⁰, Asif Halimi¹¹, Daniel Öhlund¹², Per Sandström¹³, Ernesto Sparrelid^#⁴, Bergthor Björnsson^#¹⁴

Affiliations

¹ Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. Kristina.hasselgren@liu.se.
² Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
³ Department of Surgery, The Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
⁵ Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
⁶ Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden.
⁷ Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
⁸ Department of oncology, The Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁹ Department of Oncology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
¹⁰ Department of Oncology and Haematology, Oulu University Hospital, University of Oulu, Oulu, Finland.
¹¹ Department of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Linköping, Sweden.
¹² Department of Diagnostics and Intervention and Wallenberg Centre for Molecular Medicine, Umeå University (WCMM), Umeå, Sweden.
¹³ Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
¹⁴ Department of Surgery, Linköping University Hospital, Linköping, Sweden.

^# Contributed equally.

PMID: 40682051
PMCID: PMC12275338
DOI: 10.1186/s12893-025-02983-w

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

Kristina Hasselgren et al. BMC Surg. 2025.

. 2025 Jul 19;25(1):299.

doi: 10.1186/s12893-025-02983-w.

Authors

Affiliations

¹ Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. Kristina.hasselgren@liu.se.
² Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden.
³ Department of Surgery, The Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
⁵ Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
⁶ Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden.
⁷ Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
⁸ Department of oncology, The Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁹ Department of Oncology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
¹⁰ Department of Oncology and Haematology, Oulu University Hospital, University of Oulu, Oulu, Finland.
¹¹ Department of Diagnostics and Intervention, Surgery, Umeå University, Umeå, Linköping, Sweden.
¹² Department of Diagnostics and Intervention and Wallenberg Centre for Molecular Medicine, Umeå University (WCMM), Umeå, Sweden.
¹³ Division of Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
¹⁴ Department of Surgery, Linköping University Hospital, Linköping, Sweden.

^# Contributed equally.

PMID: 40682051
PMCID: PMC12275338
DOI: 10.1186/s12893-025-02983-w

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 26^th 2022.

Keywords: Ablation; Liver metastases; Pancreatic cancer; Resection.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

**Fig. 1**
A schematic description of the study, from the identification of eligliable patients at MDT to the end of follow at 24 months post operatively

See this image and copyright information in PMC

References

1. Klein AP. Pancreatic cancer epidemiology: Understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol. 2021;18(7):493–502. - PMC - PubMed
1. Latenstein AEJ, et al. Nationwide trends in incidence, treatment and survival of pancreatic ductal adenocarcinoma. Eur J Cancer. 2020;125:83–93. - PubMed
1. Hackert T, et al. Radical surgery of oligometastatic pancreatic cancer. Eur J Surg Oncol. 2017;43(2):358–63. - PubMed
1. Schwarz C, et al. Metachronous hepatic resection for liver only pancreatic metastases. Surg Oncol. 2020;35:169–73. - PubMed
1. Adam R, et al. Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg. 2006;244(4):524–35. - PMC - PubMed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources

Medical