In the assessment of resectability of pancreatic ductal adenocarcinoma, borderline resectable disease (NCCN criteria) is defined by which arterial criterion?

• A Superior mesenteric artery encasement of any degree
• B Superior mesenteric artery encasement >180 degrees
• C Any degree of hepatic artery involvement without celiac axis involvement
• D Solid tumor contact with SMA of 180 degrees or less, or solid tumor contact with the celiac axis of 180 degrees or less ✓

Explanation

NCCN 2023 criteria for borderline resectable pancreatic cancer (arterial criteria): solid tumor contact with SMA ≤180°; solid tumor contact with celiac axis ≤180° (pancreatic head/body); solid tumor contact with first jejunal SMA branch; solid tumor contact with variant arterial anatomy (e.g., replaced right hepatic artery). Solid tumor contact with SMA >180° or any degree of SMA encasement that is irreversible, or contact with celiac axis >180°, constitutes locally advanced (unresectable) disease. The distinction determines eligibility for upfront surgery versus neoadjuvant therapy.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.