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Table 1 Case vignette

From: Treatment recommendations within the leeway of clinical guidelines: A qualitative interview study on oncologists’ clinical deliberation

Patient demographics M, 64 yrs.; married
Status praesens Nausea and pain in the upper abdomen, back pain, unintended weight loss of 6 kg, condition stable, but generally restricted.
Past medical history (PMH) Three-vessel CAD; s/p CABG occasionally AP on exertion-controlled arterial hypertension, COPD GOLD II, under medication.
Family history (FH) Unknown
Social History (SH) Smoker (60 pack-years), lives at home with his wife who supports him with domestic activities; he formerly worked as a butcher, now unfit for work.
Allergies (ALL) None
Physical examination (PE) and test results  - Slightly diminished general condition, BMI 27, 3, 140/95, heart and lungs: NAD, neurology: NAD
 - Endoscopic ultrasound: mass located in the pancreatic head, inhomogeneous
 - MRI scan abdomen: 3.5 cm mass in processus uncinatus, multiple peripancreatic lymph nodes
 - MR angiography: primary cancer not resectable: full vessel involvement and infiltration of SMA
 - Histology (endosonography): high-grade pancreatic ductal adenocarcinoma, no metastases detected
 - LAB: Hemoglobin 13.2 g/dl; Leukocyte 5200/μl; Thrombozyten 150,000/μl
  Creatinin: 1.2 mg/dl
  Bilirubin: 1.1 mg/dl
  Amylase: 100 U/l
  Lipase: 55 U/l
  CA19–9 (carbohydrate antigen 19.9): 1350 U/ml
Diagnosis Locally advanced, pancreatic ductal adenocarcinoma cT4N1M0 (UICC stage III)