Management of borderline and locally advanced pancreatic cancer: Where do we stand?

Table 1 Difference of definitions of anatomic borderline resectable pancreatic cancers from different sources

Tumor-vessel relationship on computed tomography	NCCN	MDACC	AHPBA/SSO/SSAT	Alliance
Superior mesenteric vein/portal vein	Severely narrowed or occluded with possibility of reconstruction	Occluded with possibility of reconstruction	Abutment or encasement or occlusion with possibility of reconstruction	Interface between tumor and vessel > 180°, and or reconstructable
SMA	Abutment	Abutment	Abutment	Interface between tumor and vessel < 180°
Celiac axis	No abutment or encasement	Abutment	No abutment or encasement	Reconstructable interface
Common hepatic artery	Abutment or short segment encasement	Abutment or short segment encasement	Abutment or short segment encasement	Interface between tumor and vessel < 180°

Abutment, ≤ 180° or ≤ 50% of the vessel circumference; encasement, ≥ 180° or ≥ 50% of the vessel circumference. MDACC: Anderson Cancer Center; NCCN: National Comprehensive Cancer Network; AHPBA: Hepato-Pancreato-Biliary Association; SMA: Superior mesenteric artery.

Table 2 Summary of recent chemotherapy trials for locally advanced pancreatic cancer

CHEMO trials	Component	Median survival	P value
GERCORD/GISCAD[66]	Gem ± oxaliplatin	9.0 mo vs 7.1 mo	0.13
Van Cutsem et al[67]	Gem ± tipifarnib	193 d vs 182 d	0.75
IRINOGEM[68]	Gem ± irinotecan	6.3 mo vs 6.6 mo	0.79
Von Hoff et al[69]	Gem ±nab-paclitaxel	8.5 mo vs 6.7 mo	< 0.001
PRODIGE[70]	Gem vs FOLFIRINOX	6.8 mo vs 11.1 mo	< 0.001

CHEMO: Chemotherapy; Gem: Gemcitabine.