National Comprehensive Cancer Network (NCCN) Criteria for Resectability of a Pancreatic Cancer

 

A pancreatic cancer is resectable if all of the following are present:

(1) There are no distant metastases.

(2) There is no distortion of the superior mesenteric vein on imaging studies.

(3) There is no distortion of the portal vein on imaging studies.

(4) There are clear fat planes around the superior mesenteric artery, hepatic artery and celiac axis.

 

A pancreatic cancer is borderline resectable if all of the following are present:

(1) There are no distant metastases.

(2) One or more of the following:

(2a) There is distortion of the superior mesenteric vein on imaging studies (distortion, narrowing, occlusion) with suitable vessel proximal and distal sufficient to allow for safe resection and replacement.

(2b) There is distortion of the portal vein on imaging studies (distortion, narrowing, occlusion) with suitable vessel proximal and distal sufficient to allow for safe resection and replacement.

(2c) (gastroduodenal artery encasement up to hepatic artery) AND (short segment encasement or abutment of hepatic artery) AND (no extension to the celiac axis).

(2d) tumor abutment of the superior mesenteric artery is <= 180 degrees of the vessel wall circumference

 

Tumors are considered unresectable if one or more of the following are present:

(1) there are distant metastases (including lymph nodes outside of the field of resection)

(2) > 180 degree encasement of the superior mesenteric artery

(3) tumor in head of pancreas and any celiac abutment

(4) tumor in body or tail with > 180 degree encasement of the celiac artery

(5) tumor in head or body with unreconstructable superior mesenteric vein occlusion

(6) tumor in head or body with unreconstructable portal vein occlusion

(7) tumor in head or body with aortic invasion or encasement

(8) tumor in head with inferior vena cava invasion or encasement