Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.142
Peer-review started: October 13, 2022
First decision: November 15, 2022
Revised: November 23, 2022
Accepted: January 11, 2023
Article in press: January 11, 2023
Published online: February 27, 2023
Processing time: 136 Days and 20.1 Hours
Borderline resectable pancreatic cancer (BRPC) is a complex clinical entity with specific biological features. Criteria for resectability need to be assessed in combination with tumor anatomy and oncology. Neoadjuvant therapy (NAT) for BRPC patients is associated with additional survival benefits. Research is currently focused on exploring the optimal NAT regimen and more reliable ways of assessing response to NAT. More attention to management standards during NAT, including biliary drainage and nutritional support, is needed. Surgery remains the cornerstone of BRPC treatment and multidisciplinary teams can help to evaluate whether patients are suitable for surgery and provide individualized management during the perioperative period, including NAT responsiveness and the selection of surgical timing.
Core Tip: Borderline resectable pancreatic cancer (BRPC) is a type of pancreatic cancer with specific biological characteristics. To date, there is no unified comprehensive management for this disease. Thus, an evaluation of BRPC resection and neoadjuvant therapy (NAT) is needed. This review summarizes new resection methods and different NAT schemes, including treatment efficacy evaluation and management. This study also discusses the current progress of surgical treatment and the use of multidisciplinary teams to provide comprehensive multimodal management of BRPC treatment.