Mikulic D, Mrzljak A. Borderline resectable pancreatic cancer and vascular resections in the era of neoadjuvant therapy. World J Clin Cases 2021; 9(20): 5398-5407 [PMID: 34307593 DOI: 10.12998/wjcc.v9.i20.5398]
Corresponding Author of This Article
Danko Mikulic, FEBS, MD, PhD, Surgeon, Department of Surgery, University Hospital Merkur, Zajceva 19, Zagreb 10000, Croatia. danko.mikulic@zg.t-com.hr
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
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 Clin Cases. Jul 16, 2021; 9(20): 5398-5407 Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5398
Borderline resectable pancreatic cancer and vascular resections in the era of neoadjuvant therapy
Danko Mikulic, Anna Mrzljak
Danko Mikulic, Department of Surgery, University Hospital Merkur, Zagreb 10000, Croatia
Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
Author contributions: Mikulic D and Mrzljak A made contributions to the conception and design of the study, collecting of data and in drafting and revising the manuscript; both authors read and approved the final manuscript.
Conflict-of-interest statement: The authors have any conflict of interest to declare.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Danko Mikulic, FEBS, MD, PhD, Surgeon, Department of Surgery, University Hospital Merkur, Zajceva 19, Zagreb 10000, Croatia. danko.mikulic@zg.t-com.hr
Received: January 27, 2021 Peer-review started: January 27, 2021 First decision: February 25, 2021 Revised: March 1, 2021 Accepted: May 27, 2021 Article in press: May 27, 2021 Published online: July 16, 2021
Abstract
While pancreatic cancer is still characterized by early systemic spread and poor outcomes, the treatment of this disease has changed significantly in recent years due to major advancements in systemic therapy and advanced surgical techniques. Broader use of effective neoadjuvant approaches combined with aggressive surgical operations within a multidisciplinary setting has improved outcomes. Borderline resectable pancreatic cancer is characterized by tumor vascular invasion, and is a setting where the combination of potent neoadjuvant chemotherapy and aggressive surgical methods, including vascular resections and reconstructions, shows its full potential. Hopefully, this will lead to improved local control and curative treatment in a number of patients with this aggressive malignancy.
Core Tip: Curative treatment of pancreatic ductal adenocarcinoma is only possible after margin negative surgical resection. Borderline resectable pancreatic cancer is characterized by vascular tumor involvement and the need to perform vascular resection to achieve radical resection. This report reviewed the characteristics of borderline resectable pancreatic cancer and the current treatment perspectives, including aggressive surgical approaches in the era of neoadjuvant therapy.
