title: Selection criteria in resectable pancreatic cancer: a biological and morphological approach.
abstract: Pancreatic ductal adenocarcinoma (PDA) remains one of the most aggressive tumors with a low rate of survival. Surgery is the only curative treatment for PDA, although only 20% of patients are resectable at diagnosis. During the last decade there was an improvement in survival in patients affected by PDA, possibly explained by the advances in cancer therapy and by improve patient selection by pancreatic surgeons. It is necessary to select patients not only on the basis of surgical resectability, but also on the basis of the biological nature of the tumor. Specific preoperative criteria can be identified in order to select patients who will benefit from surgical resection. Duration of symptoms and level of carbohydrate antigen 19.9 in resectable disease should be considered to avoid R1 resection and early relapse. Radiological assessment can help surgeons to distinguish resectable disease from borderline resectable disease and locally advanced pancreatic cancer. Better patient selection can increase survival rate and neoadjuvant treatment can help surgeons select patients who will benefit from surgery.
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Tamburrino
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Partelli
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Crippa
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Manzoni
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Maurizi
authors.affiliation: Domenico Tamburrino, Stefano Partelli, Stefano Crippa, Alberto Manzoni, Angela Maurizi, Massimo Falconi, Pancreatic Surgery Unit, Department of Surgery, Polytechnic University of Marche Region, 60126 Ancona-Torrette, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen
keywords: Borderline resectable pancreatic cancer; Pancreatic cancer; Pancreatic cancer staging; Pancreatic ductal adenocarcinoma; Pancreatic surgery