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• W4313247961 abstract "Pancreatic ductal adenocarcinoma (PDAC) remains a significant worldwide health problem with a poor prognosis. A borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) is a tumor with limited vascular involvement that is technically resectable but with a high risk of positive margins (R1 resection).To identify the current challenges that exist in the management of BR-PDAC.A review of the literature was conducted to identify articles discussing the definitions and management of BR-PDAC.Several anatomic definitions of BR-PDAC exist, and there is significant heterogeneity in their utilization across published trials. To improve the odds of a margin negative (R0) resection, a neoadjuvant treatment approach involving chemotherapy with or without radiation is currently preferred. While supporting the efficacy of a neoadjuvant approach in BR-PDAC, the largest published randomized trials have utilized older gemcitabine-based regimens. Recently published Phase II evidence and meta-analyses have supported the use of modern multi-agent regimens such as FOLFIRINOX. The utility of adding radiation to a chemotherapy backbone remains in question. Due to remnant fibrosis and edema following neoadjuvant therapy, accurately selecting patients for resection based on a restaging CT scan is challenging. Furthermore, the role of adjuvant therapy in BR-PDAC patients receiving neoadjuvant therapy needs to be defined.Though progress has been made, the optimal management of BR-PDAC is uncertain. Phase III trials utilizing modern chemotherapeutic regimens are needed to establish a standard of care." @default.
• W4313247961 created "2023-01-06" @default.
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• W4313247961 date "2022-12-01" @default.
• W4313247961 modified "2023-10-14" @default.
• W4313247961 title "Borderline Resectable Pancreatic Cancer: Challenges for Clinical Management" @default.
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• W4313247961 doi "https://doi.org/10.2147/cmar.s340719" @default.
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• W4313247961 hasPublicationYear "2022" @default.
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