ArticleEuropean radiology2021
Preoperative assessment of the resectability of pancreatic ductal adenocarcinoma on CT according to the NCCN Guidelines focusing on SMA/SMV branch invasion.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 23 citations in OpenAlex.
- Pancreatic cystic lesions revisited: morphologic patterns and diagnostic pitfalls in daily practice.Abdominal radiology (New York) · 2026Review
- Scan Range and Radiation Dose of the Ultra-High-Resolution Series in Pancreatic Photon-Counting Detector CT: A Prospective Two-Group Comparison of an Ultra-Low-Dose Planning Series.Diagnostics (Basel, Switzerland) · 2026Article
- Survival Outcomes According to NCCN Criteria for Resection Following Neoadjuvant Therapy for Patients with Localized Pancreatic Cancer.Annals of surgical oncology · 2025Article
- Multimodal treatment combining neoadjuvant therapy, laparoscopic subtotal distal pancreatectomy and adjuvant therapy for pancreatic neck-body cancer: Case series.World journal of gastrointestinal surgery · 2025Article
- Precision Targeting Strategies in Pancreatic Cancer: The Role of Tumor Microenvironment.Cancers · 2024Review
- Comparison of the different versions of NCCN guidelines for predicting margin-negative resection of pancreatic cancer in patients undergoing upfront surgery.Abdominal radiology (New York) · 2024Article
- Imaging of pancreatic ductal adenocarcinoma - An update for all stages of patient management.European journal of radiology open · 2024Article
- Pancreas CT assessment for pancreatic ductal adenocarcinoma resectability: effect of tube voltage and slice thickness on image quality and diagnostic performance.Cancer imaging : the official publication of the International Cancer Imaging Society · 2023Article
- Pancreatic index: A prognostic factor of upfront surgery for body or tail pancreatic ductal adenocarcinoma with vascular involvement-A retrospective study.Cancer medicine · 2023Article
- High-resolution pancreatic computed tomography for assessing pancreatic ductal adenocarcinoma resectability: a multicenter prospective study.European radiology · 2023Article
- Development and validation of an MRI-radiomics nomogram for the prognosis of pancreatic ductal adenocarcinoma.Frontiers in oncology · 2023Article
- A nomogram diagnostic prediction model of pancreatic metastases of small cell lung carcinoma based on clinical characteristics, radiological features and biomarkers.Frontiers in oncology · 2022Article
- Neoadjuvant Treatment in Resectable Pancreatic Cancer. Is It Time for Pushing on It?Frontiers in oncology · 2022Review
- Why surgeons care about systemic chemotherapy for pancreatic cancer?Hepatobiliary surgery and nutrition · 2021Article
- Focal Pancreatic Lesions: Role of Contrast-Enhanced Ultrasonography.Diagnostics (Basel, Switzerland) · 2021Review
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFor patients with pancreatic adenocarcinoma (PAC), adequate determination of disease extent is critical for optimal management. We aimed to evaluate diagnostic accuracy of CT in determining the resectability of PAC based on 2020 NCCN Guidelines.
methodsWe retrospectively enrolled 368 consecutive patients who underwent upfront surgery for PAC and preoperative pancreas protocol CT from January 2012 to December 2017. The resectability of PAC was assessed based on 2020 NCCN Guidelines and compared to 2017 NCCN Guidelines using chi-square tests. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using log-rank test. R0 resection-associated factors were identified using logistic regression analysis.
resultsR0 rates were 80.8% (189/234), 67% (71/106), and 10.7% (3/28) for resectable, borderline resectable, and unresectable PAC according to 2020 NCCN Guidelines, respectively (p < 0.001). The estimated 3-year OS was 28.9% for borderline resectable PAC, which was significantly lower than for resectable PAC (43.6%) (p = 0.004) but significantly higher than for unresectable PAC (0.0%) (p < 0.001). R0 rate was significantly lower in patients with unresectable PAC according to 2020 NCCN Guidelines (10.7%, 3/28) than in those with unresectable PAC according to the previous version (31.7%, 20/63) (p = 0.038). In resectable PAC, tumor size ≥ 3 cm (p = 0.03) and abutment to portal vein (PV) (p = 0.04) were independently associated with margin-positive resection.
conclusionsThe current NCCN Guidelines are useful for stratifying patients according to prognosis and perform better in R0 prediction in unresectable PAC than the previous version. Larger tumor size and abutment to PV were associated with margin-positive resection in patients with resectable PAC. KEY POINTS: • The updated 2020 NCCN Guidelines were useful for stratifying patients according to prognosis. • The updated 2020 NCCN Guidelines performed better in the prediction of margin-positive resection in unresectable cases than the previous version. • Tumor size ≥ 3 cm and abutment to the portal vein were associated with margin-positive resection in patients with resectable pancreatic adenocarcinoma.
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