Wu HY, Li JW, Li JZ, Zhai QL, Ye JY, Zheng SY, Fang K. Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress. World J Gastrointest Surg 2023; 15(2): 142-162 [PMID: 36896309 DOI: 10.4240/wjgs.v15.i2.142]
Corresponding Author of This Article
Kun Fang, MD, Research Assistant, Surgical Oncologist, Department of Surgery, Yinchuan Maternal and Child Health Hospital, No. 56 Wenhua West Road, Xingqing District, Yinchuan 750000, Ningxia, China. k99ftl@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2023; 15(2): 142-162 Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.142
Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress
Hong-Yu Wu, Jin-Wei Li, Jin-Zheng Li, Qi-Long Zhai, Jing-Yuan Ye, Si-Yuan Zheng, Kun Fang
Hong-Yu Wu, Jin-Zheng Li, Qi-Long Zhai, Jing-Yuan Ye, Si-Yuan Zheng, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Jin-Wei Li, Department of Neurosurgery, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545000, Guangxi Province, China
Kun Fang, Department of Surgery, Yinchuan Maternal and Child Health Hospital, Yinchuan 750000, Ningxia, China
Author contributions: Wu HY, Zhai QL and Li JW were responsible for collating literatures, producing figures and tables and writing the paper; Ye JY and Zheng SY performed the literature search and language translation; Li JZ and Fang K reviewed the paper and approved the vision of the article to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kun Fang, MD, Research Assistant, Surgical Oncologist, Department of Surgery, Yinchuan Maternal and Child Health Hospital, No. 56 Wenhua West Road, Xingqing District, Yinchuan 750000, Ningxia, China. k99ftl@163.com
Received: October 13, 2022 Peer-review started: October 13, 2022 First decision: November 15, 2022 Revised: November 23, 2022 Accepted: January 11, 2023 Article in press: January 11, 2023 Published online: February 27, 2023 Processing time: 136 Days and 20.1 Hours
Abstract
Borderline resectable pancreatic cancer (BRPC) is a complex clinical entity with specific biological features. Criteria for resectability need to be assessed in combination with tumor anatomy and oncology. Neoadjuvant therapy (NAT) for BRPC patients is associated with additional survival benefits. Research is currently focused on exploring the optimal NAT regimen and more reliable ways of assessing response to NAT. More attention to management standards during NAT, including biliary drainage and nutritional support, is needed. Surgery remains the cornerstone of BRPC treatment and multidisciplinary teams can help to evaluate whether patients are suitable for surgery and provide individualized management during the perioperative period, including NAT responsiveness and the selection of surgical timing.
Core Tip: Borderline resectable pancreatic cancer (BRPC) is a type of pancreatic cancer with specific biological characteristics. To date, there is no unified comprehensive management for this disease. Thus, an evaluation of BRPC resection and neoadjuvant therapy (NAT) is needed. This review summarizes new resection methods and different NAT schemes, including treatment efficacy evaluation and management. This study also discusses the current progress of surgical treatment and the use of multidisciplinary teams to provide comprehensive multimodal management of BRPC treatment.
