Table 3. Comparison of Resectability Criteria for Pancreatic Cancer without Distant Metastasis.
| Resectability Status | Resectability Criteria | |||
|---|---|---|---|---|
| MD Anderson (14) | AHPBA/SSAT/SSO (6) | Alliance (60) | NCCN (7) | |
| Celiac artery | ||||
| Resectable | No involvement | No involvement | No involvement | No involvement |
| Borderline | Short-segment abutment or encasement | Abutment (≤ 180°) | Abutment (≤ 180°) (Body/tail only) encasement (> 180°) without aorta nor gastroduodenal artery, reconstructable with modified Appleby procedure |
|
| Locally advanced | Encasement and no technical option for reconstruction | Any involvement | Encasement (> 180°) | (Head/uncinate only) encasement (> 180°) (Body/tail only) encasement (> 180°), surgically unreconstructable |
| CHA | ||||
| Resectable | No involvement | No involvement | No involvement | No involvement |
| Borderline | Short-segment abutment or encasement | Abutment (≤ 180°) or gastroduodenal artery encasement up to hepatic artery | Any surgically reconstructable involvement | Any involvement without celiac axis or CHA bifurcation |
| Locally advanced | Encasement and no technical option for reconstruction | Encasement (> 180°) | Surgically unreconstructable involvement | Any involvement with celiac axis or CHA bifurcation |
| SMV | ||||
| Resectable | No involvement | No involvement | No involvement | No involvement |
| Borderline | Abutment (≤ 180°) | Abutment (≤ 180°) | Abutment (≤ 180°) | Abutment (≤ 180°) |
| Locally advanced | Encasement (> 180°) | Encasement (> 180°) | Encasement (> 180°) | Encasement (> 180°) |
| SMV/PV | ||||
| Resectable | Patent | No abutment, distortion, tumor thrombus, or encasement | No involvement or abutment (≤ 180°) | No involvement or abutment (≤ 180°), without vein contour irregularity |
| Borderline | Short-segmental occlusion and surgically reconstructable | Any surgically reconstructable involvement | Any surgically reconstructable involvement | Encasement (> 180°), or abutment (≤ 180°) with venous contour irregularity or thrombosis, but surgically reconstructable |
| Locally advanced | Occluded and no technical option for reconstruction | Surgically unreconstructable involvement | Surgically unreconstructable involvement | Surgically unreconstructable involvement or occlusion |
AHPBA = American Hepato-Pancreato-Biliary Association, NCCN = National Comprehensive Cancer Network, PV = portal vein, SMV = superior mesenteric vein, SSAT = Society for Surgery of the Alimentary Tract, SSO = Society of Surgical Oncology