Table 1.

NCCN criteria for PDAC resectability status at diagnosis based on pancreatic CT.

Resectability	Arterial Involvement	Venous Involvement
Resectable	No tumor contact with major arterial structures (CA, SMA, and/or CHA)	No tumor contact with SMV or PV ≤180° contact WITHOUT vein contour irregularity
Borderline Resectable	Pancreatic head/uncinate process: Solid tumor contact with CHA without extension to CA or hepatic artery bifurcation Solid tumor contact with the SMA of ≤180° Solid tumor contact with variant arterial anatomy (example: accessory right hepatic artery, replaced right hepatic artery, replaced CHA, etc.) Pancreatic body/tail: Solid tumor contact with the CA of ≤180°	Solid tumor contact with the SMV or PV of >180° ≤180° solid tumor contact with contour irregularity of the vein or thrombosis of the vein BUT with suitable vessel proximal and distal to the site of involvement, allowing for adequate vein resection and reconstruction Solid tumor contact with the inferior vena cava
Locally Advanced	Pancreatic head/uncinate process: Solid tumor contact >180° with the SMA or CA Pancreatic body/tail: Solid tumor contact of >180° with the SMA or CA Solid tumor contact with the CA and aortic involvement	Unreconstructible SMV or PV due to extensive tumor involvement or venous occlusion

Note: all recommendations are category 2A (uniform NCCN consensus that the intervention is appropriate based on lower-level evidence) [27].