Resectable PDAC treated with neoadjuvant chemotherapy with a median overall survival rate of months after surgical resection compared to 8.1 months without resection (Christians et al., 2016). Neoadjuvant therapy usually involves either FOLFIRINOX (folinic acid, fluorouracil, irinotecan, and oxaliplatin) or albumin-bound paclitaxel plus gemcitabine (Seufferlein et al., 2012). In another study involving patients with stage I or II pancreatic cancer, those who received neoadjuvant chemotherapy and resection had a median overall.
Survival rate of 26 months compared to 21 months in patients who had upfront resection without chemotherapy (Mokdad et al., 2017). Studies have repeatedly Spain phone number list illustrated the importance of neoadjuvant therapy in reducing tumor size prior to surgery and limiting micrometastatic disease as well as the importance of resection in general for overall survival (Brown et al., 2022). There is growing evidence to suggest these patients with BR disease, in particular, may benefit from neoadjuvant chemotherapy before surgery to increase the odds of R0 or negative margins after resection.
However, classifying PDAC into resectable, borderline unresectable, and unresectable is not always straightforward. The decision on resectability is typically multidisciplinary, with variable definitions of what is truly resectable among varying institutions (NCCN, 2022). Most definitions, however, do focus on vascular invasion on imaging with the criteria created by the National Comprehensive Cancer Network (NCCN) probably being the most used. Multiphase multi-detector computed tomography (MDCT) is the first-line imaging modality for the diagnosis of pancreatic cancer.