Borderline resectable pancreatic cancer: More than an anatomical concept

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• 作者：Fausto Petrelli^a ; ^{faupe@libero.it} ; Alessandro Inno^b ; Sandro Barni^a ; Antonio Ghidini^c ; Roberto Labianca^d ; Massimo Falconi^e ; Michele Reni^f ; Stefano Cascinu^g ; on behalf of GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell&rsquo ; Apparato Digerente) ; San Raffaele Hospital
• 关键词：Borderline resectable ; Pancreatic cancer ; Treatment
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：49
• 期：2
• 页码：223-226
• 全文大小：396 K
• 卷排序：49

文摘

Borderline resectable pancreatic cancer (BRPC) accounts for about 10–15% of newly diagnosed pancreatic cancer, and its management requires a skilled multidisciplinary team. The main definition of BRPC refers to resectability, but also a high risk of positive surgical margins and recurrence. This raises questions about the value of surgery and suggests an opportunity to utilize preoperative treatment in this subset of patients.Besides technical borderline resectable disease which is defined on anatomical and radiological criteria, there is also a biological borderline resectable disease which is defined on clinical and biological prognostic factors. Technical borderline resectable disease requires tumor shrinkage with aggressive therapy including modern drug combinations +/− radiotherapy to achieve radical surgery. Biological BRPC needs always an early systemic treatment in order to select the best candidates for subsequent radical surgery. It is important to distinguish between these different clinical scenarios, both in clinical practice and for clinical trials design.