Pancreatic cancer-improved care achievable

Table 1 Staging of pancreatic cancer according to the American Joint Committee on Cancer[48], together with clinical implication for resectability, illustrating that T3 and even T4 tumors may be considered borderline resectable

Stage	Tumor grade1	Nodal status1	Distant metastases1	Resectability
IA	T1	N0	M0	Resectable
IB	T2	N0	M0
IIA	T3	N0	M0	Borderline resectable2
IIB	T1, T2 or T3	N1	M0
III	T4	Any N	M0
IV	Any T	Any N	M1	Unresectable, independent of T-grade

¹N denotes regional lymph nodes, M distant metastases, and T primary tumor;

²The concept “borderline resectable”, related to T3 and T4 tumors, is not uniformly conceived between pancreatic centers.

Table 2 Core data, characterizing outcome of neoadjuvant chemoradiation and surgery, vs upfront surgery plus adjuvant chemotherapy in patients with resectable and/or borderline resectable pancreatic tumor

Ref.	Patients included	Inclusion periode	Treatment algorithm	Proportion not resected	R0 status	Frequency of vascular resection	Median survival in months
Katz et al[63] 2008	160	1999-2006	Neo-adjuvant	59%	94%	27%	40
Nordby et al[84] 2013	135	2008-2010	Upfront surgery+ adjuvance	11%	42%	6%	Na1
Neop-tolemos et al[76] 2010	1088	2000-2007	Upfront surgery+ adjuvance	Only resected patients included	65%	17%	23
Schmidt et al[77] 2012	132	2004-2007	Upfront surgery+ adjuvance	Only resected patients included	61%	Na2	28

Na1: Too short follow up; Na2: Not given in the paper.