Copyright ©The Author(s) 2021.
World J Gastroenterol. Sep 21, 2021; 27(35): 5851-5889
Published online Sep 21, 2021. doi: 10.3748/wjg.v27.i35.5851
Table 1 Genetic syndromes predisposing to pancreatic cancer (the frequency of mutated genes among patients with pancreatic ductal adenocarcinoma is indicated in brackets)
Genetic syndrome
Mutated genes
Hereditary breast/ovarian cancer syndrome[36,37]BRCA1 (0.7%), BRCA2 (1.4%), PALB2 (1%)
Familial atypical multiple mole melanoma syndrome[38]CDKN2A (0.7%)
Peutz-Jeghers syndrome[39]STK11
Familial adenomatous polyposisAPC (0.4%)
Lynch syndrome[40]MLH1, MSH2 (0.4%), PMS2 (0.3%)
Hereditary pancreatitis[41]PRSS1, SPINK1
Ataxia telangectasia[42]ATM (1.4%)
Li-Fraumeni syndrome[42]P53 (0.4%)
Table 2 Resectability criteria
Resectability status
Borderline resectable
Locally advanced
Arterial involvementCeliac arteryNone≤ 180°; > 180°, without involvement of aorta o GDA (body/tail)>180° (head/uncinate); Solid tumor contact with CA and aorta
SMA common hepatic arteryNone≤ 180°; Solit tumor contact without extension into CA or hepatic artery biforcation> 180°
Venous involvement (portal vein/smv)None; ≤ 180° contact without contour irregularity> 180°; ≤ 180° with contour irregularity or thrombosis, with reconstructible PV/SMV; Solid tumor contact with IVCUnreconstractible PV/SMV due to tumor involvement or occlusion
Table 3 Resectability criteria and societies
Vessel involvement
NCCN 2019
CA abutment (≤ 180°)BorderlineBorderlineBorderlineUnresectable
CA encasement (> 180°)Borderline (body/tail); locally advanced (head/uncinate)UnresectableUnresectableUnresectable
SMA abutment (< 180°); SMA encasement (> 180°); CHA abutment or encasementBorderline; Locally advanced; BorderlineBorderline; Unresectable; BorderlineBorderline; Unresectable; BorderlineBorderline; Unresectable; Borderline
PV/SMV encasement (> 180°) or abutment (≤ 180°) with contour abnormalityBorderlineBorderlineBorderlineBorderline
Table 4 Phase of trial and level of evidence of trial about chemotherapy for resectable and borderline resectable pancreatic ductal adenocarcinoma
Phase of trial
Level of evidence
Neoptolemos et al[185]IIIII
Oettle et al[186]IIII
Neoptolemos et al[187]IIII
Neoptolemos et al[188]IIII
Conroy et al[189]IIII
You et al[195]IIIII
van Roessel et al[198]IVII
Versteijne et al[202]IIIII
Ghaneh et al[205]IIII
Sohal et al[207]IVII
Labori et al[209]IIIII
Schwarz et al[210]III
Ettrich et al[211]IIII
Motoi et al[212]IIIII
UMIN-CTR Clinical Trial[215] (UMIN000026858)IIIII
Table 5 Phase and level of evidence of trials about immunotherapy for pancreatic ductal adenocarcinoma
Phase of trial
Level of evidence
Royal et al[245]IIII
Brahmer et al[246]II
O'Reilly et al[247]IIII
Tumeh et al[248]IIIII
Le et al[250]IIII
Le et al[251]IIII
Wainberg et al[252]III
Weiss et al[253]Ib/IIII
National Institute of Public Health[254] (JapicCTI-184230,ONO-4538)IIII
Wang-Gillam et al[255]IIII
Le et al[257]IIbI
Asahara et al[258]I/IIII
Suzuki et al[259]IIIII
Miyazawa et al[260]IIII
Wedén et al[261]IVIII
Toubaji et al[262]IIII
Abou-Alfa et al[263]I/IIIII
Cohn et al[264]IIII
Katsuda et al[265]IIII
Katsuda et al[266]I/IIII
Beatty et al[270]IIII
Le et al[271]IbII
Chung et al[272]IIII
Wang-Gillam et al[273]IIII
Reiss et al[274]IIIII
Desai et al[275]Ib/IIOngoing trial
Chang et al[278]IIII
Noonan et al[279]IIII
Mahalingam et al[280]IbIII