Controversies in the Management of Borderline Resectable Proximal Pancreatic Adenocarcinoma with Vascular Involvement

Table 2

M. D. Anderson criteria for defining resectability status of pancreatic cancer [3, 4].

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Resectable

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(i) No distant metastases

(ii) No extension to the SMA; normal fat plant between the tumour and SMA

(iii) No extension to the coeliac axis or HA

(iv) Patent SMV/PV

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Borderline resectable

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(i) Tumour abutment ≤180^° (≤50%) of the circumference of the SMA

(ii) Short-segment encasement/abutment of the CHA (typically at the GDA origin)

(iii) Short-segment occlusion of the SMV/PV with suitable vessel above and below

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Unresectable

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(i) Encased SMA (>180^°)

(ii) Encased HA with no technical option for reconstruction

(iii) Occluded SMV/PV wih no technical option for reconstruction

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CHA = common hepatic artery
GDA = Gastroduodenal artery
HA = Hepatic artery
PV = Portal vein
SMV = Superior mesenteric vein
SMA = Superior mesenteric artery.