Current status and progress in assessment of resectability of pancreatic cancer after neoadjuvant chemotherapy

doi:10.3877/cma.j.issn.2095-3232.2024.05.007

Abstract

Abstract:

Pancreatic cancer is one of the tumors with the worst prognosis. R0 resection is the only option to achieve long-term survival. To improve the R0 resection rate, National Comprehensive Cancer Network (NCCN) guidelines recommends neoadjuvant chemotherapy for borderline resectable and locally advanced stage patients. However, the assessment of tumor resectability after neoadjuvant chemotherapy, especially in borderline resectable patients, brings huge challenges to surgeons. Both CT and MRI tend to underestimate the resectability of tumors. Dynamic detection of CA19-9, evaluation of imaging data and general condition and MDT consultation are recommended to evaluate whether patients can benefit from surgery. PET-CT, next-generation sequencing and circulating tumor DNA detection should be performed to assist diagnosis when necessary according to the individual conditions of patients. With persistent advancement of clinical evidence such as imaging, artificial intelligence (AI)-assisted film reading, genetic testing and liquid biopsy, surgeons will deliver more accurate prediction for tumor resectability.

Key words: Pancreatic neoplasms, Pancreatic duct adenocarcinoma, Neoadjuvant chemotherapy (NAT), Resectability

Hao Zhang, Weidong Pan. Current status and progress in assessment of resectability of pancreatic cancer after neoadjuvant chemotherapy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 629-633.

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