, Volume 17, Issue 11, pp 2803-2805

Borderline Resectable Pancreatic Cancer: Definitions and the Importance of Multimodality Therapy

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The exceedingly high rates of distant metastatic recurrence following successful surgical resection of early-stage tumors would suggest that pancreatic adenocarcinoma is a systemic disease at the time of diagnosis in the vast majority of patients, and therefore a compelling case can be made for a neoadjuvant treatment approach in almost all patients. Although the first national trial of neoadjuvant therapy for resectable pancreatic cancer (ACOSOG Z5041) only recently opened, single-institution experiences have supported this form of treatment sequencing for nearly two decades. However, outside of large referral centers with disease-specific investigators committed to clinical and translational research in pancreatic cancer, confusion remains over how to define, on preoperative imaging, what is resectable and what is not (so called locally advanced or borderline resectable pancreatic cancer). In an attempt to clarify the anatomy of resectable, borderline, and locally advanced disease, V