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Defining and Treating Borderline Resectable Pancreatic Cancer

  • Upper Gastrointestinal Cancers (JD Berlin, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Patients with borderline resectable pancreatic ductal adenocarcinoma (BR PDAC) should receive preoperative chemotherapy with or without radiation therapy, with the intent to eradicate occult metastatic cancer cells, to select patients with a “locally dominant cancer phenotype” for whom local therapies might be most effective, and to reduce the anatomic extent of tumors to facilitate surgical resection. The administration of preoperative therapy may also be a useful strategy to deliver the maximum load of chemotherapy to patients with BR PDAC, since as many as half of patients will never qualify for adjuvant treatments following pancreatectomy due to postoperative morbidity or disease progression. Patients with BR PDAC should be categorized at diagnosis on the basis of anatomical, biological, and conditional criteria and should be offered induction systemic chemotherapy with close monitoring for toxicity, followed by administration of (chemo)radiation in selected cases. Patients should be restaged after systemic therapy and, if used, (chemo)radiation. Patients who continue to show disease response or disease stability without signs of progression should be considered for pancreatectomy; better measures of response to therapy are needed.

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  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, FCT 17.6058, Unit 1484, Houston, TX, 77030, USA

    Giampaolo Perri MD, Laura Prakash MD & Matthew H. G. Katz MD

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Correspondence to Matthew H. G. Katz MD.

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Perri, G., Prakash, L. & Katz, M.H.G. Defining and Treating Borderline Resectable Pancreatic Cancer. Curr. Treat. Options in Oncol. 21, 71 (2020). https://doi.org/10.1007/s11864-020-00769-1

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