Skip to main content

Table 2 The defining criteria of tumor resectability according to the National Comprehensive Network (NCCN) guidelines (2019) and the International Association of Pancreatology (IAP) consensus (2016)

From: Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review

ResectibilityNCCN (2019)IPA consensus (2016)
Resectable• No tumor-vessel contact• Same
180° tumor contact with SMV/PV WITHOUT venous contour irregularity• Unilateral narrowing of the vein
Borderline resectable (veins)• > 180° tumor contact with SMV/PV
• ≤ 180° tumor contact with SMV/PV + venous contour irregularity or thrombosis if the vein is reconstructible
• Tumor contact with IVC
• > 180° tumor contact with SMV/PV or bilateral narrowing or occlusion without extension beyond the inferior border of the duodenum
Borderline resectable (arteries)• ≤ 180° tumor contact with CA/SMA• ≤ 180° tumor contact with CA/SMA but without artery deformity or stenosis
• Tumor contact with CHA WITHOUT extension to CA or HA bifurcation• Same
• Tumor contact with a variant arterial anatomy• Not included
Unresectable• Metastasis “including non-regional LN”
• > 180° tumor contact with CA or SMA
• Tumor contact with Aorta
• Same
• Unreconstructible SMV/PV due to tumor invasion or bland/tumor thrombosis• Occlusion or bilateral narrowing of SMV/PV extending beyond the inferior border of the duodenum
• Tumor contact with the most proximal draining jejunal branch into SMV or the first jejunal SMA branch• Not included
  1. SMV superior mesenteric vein, PV portal vein, CA celiac artery, CHA common hepatic artery, SMA superior mesenteric artery