Fast Five Quiz: Test Your Knowledge of the Diagnosis and Treatment of Locally Advanced, Unresectable Pancreatic Cancer

Michael J. Pishvaian, MD, PhD

Disclosures

September 26, 2018

The delineation between borderline resectable and locally advanced, unresectable pancreatic tumors is marked by the relative proximity of the tumor with important close vascular structures. The criteria below provide more detail. Broadly speaking, in locally advanced unresectable disease, the arteries are encased (surrounded by tumor for more than 180⁰ of its circumference), while the veins, once the tumor has been removed, are not able to be reconstructed.

NCCN and AHPBA criteria for borderline and locally advanced unresectable tumors of the pancreas can be summarized as follows:

Resectability Vascularization
Superior Mesenteric Vein or Portal Vein Superior Mesenteric Artery Common Hepatic Artery Celiac Axis
Resectable Abutment or no contact No contact No contact No contact
Borderline Abutment, encasement, or occlusion Abutment Abutment or short segment encasement Abutment
Locally advanced pancreatic carcinoma Not reconstructible Encasement Long segment encasement Encasement

Abutment refers to contact between tumor and vessel wall of less than 180° of the circumference.

To learn more about the definition and classification of locally advanced, unresectable pancreatic adenocarcinoma, read here.

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