Neoadjuvant treatment in resectable pancreatic cancer: Why is upfront surgery so hard to be beaten?

Table 3 Rational regarding putative pros cons of neoadjuvant treatment for both resectable and borderline pancreatic adenocarcinoma

Advantages	Disadvantages
Delivery of systemic therapy	Complications of pre-treatment procedures (biopsy, stents, etc.)
Increased efficacy of radiation	Occasional limiting toxicity due the treatment delaying surgical treatment
Removal of irradiated tissues	Occasional drop out due to either limiting toxicity or tumor progression
Increasing in R0 rates	No proven benefit for resectable lesions in randomized clinical trials
Decreasing of fistula rates