A 60-year-old man is diagnosed with pancreatic head carcinoma. CT shows the superior mesenteric vein (SMV) abutment without encasement. Which of the following BEST describes the resectability status per NCCN criteria?
- A Borderline resectable — venous abutment ≤180° without contour irregularity ✓
- B Resectable — no vascular involvement
- C Locally advanced — venous contact alone makes it unresectable
- D Metastatic — requires palliative chemotherapy only
Correct answer: A. Borderline resectable — venous abutment ≤180° without contour irregularity
Explanation
Per NCCN guidelines, pancreatic head carcinoma with SMV/portal vein (PV) contact of ≤180° without contour irregularity is classified as borderline resectable. Resectable tumors have no vascular contact. Locally advanced tumors have unreconstructable SMV/PV involvement or SMA/celiac encasement >180°. Borderline resectable disease warrants neoadjuvant therapy followed by restaging to reassess surgical candidacy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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