Siegel, R. L. et al. Cancer statistics, 2022. CA Cancer J. Clin. 72, 7–33 (2022).

Article  PubMed  Google Scholar 

Rahib, L. et al. Estimated projection of US cancer incidence and death to 2040. JAMA Netw. Open. 4, e214708 (2021).

Article  PubMed  PubMed Central  Google Scholar 

Mizrahi, J. D., Surana, R., Valle, J. W. & Shroff, R. T. et al. Pancreatic cancer. Lancet 395, 2008–2020 (2020).

Article  CAS  PubMed  Google Scholar 

Springfeld, C. et al. Neoadjuvant therapy for pancreatic cancer. Nat. Rev. Clin. Oncol. 20, 318–337 (2023).

Article  PubMed  Google Scholar 

Strobel, O. et al. Optimizing the outcomes of pancreatic cancer surgery. Nat. Rev. Clin. Oncol. 16, 11–26 (2019).

Article  CAS  PubMed  Google Scholar 

Groot, V. P. et al. Patterns, timing, and predictors of recurrence following pancreatectomy for pancreatic ductal adenocarcinoma. Ann. Surg. 267, 936–945 (2018).

Article  PubMed  Google Scholar 

Daamen, L. A. et al. Preoperative predictors for early and very early disease recurrence in patients undergoing resection of pancreatic ductal adenocarcinoma. HPB 24, 535–546 (2022).

Article  PubMed  Google Scholar 

Seelen, L. W. F. et al. Early recurrence after resection of locally advanced pancreatic cancer following induction therapy: an international multicenter study. Ann. Surg. 278, 118–126 (2023).

Article  PubMed  Google Scholar 

Neoptolemos, J. P. et al. Comparison of adjuvant gemcitabine and capecitrabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicenter, open-label, randomised, phase 3 trial. Lancet 389, 1011–1024 (2017).

Article  CAS  PubMed  Google Scholar 

Conroy, T. et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N. Engl. J. Med. 379, 2395–2406 (2018).

Article  CAS  PubMed  Google Scholar 

Conroy, T. et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N. Engl. J. Med. 364, 1817–1825 (2011).

Article  CAS  PubMed  Google Scholar 

Von Hoff, D. D. et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N. Engl. J. Med. 369, 1691–1703 (2013).

Article  Google Scholar 

Muller, P. C. et al. Neoadjuvant chemotherapy in pancreatic cancer: an appraisal of the current high-level evidence. Pharmacology 106, 143–153 (2020).

Article  PubMed  Google Scholar 

Brown, Z. J. & Cloyd, J. M. Trends in the utilization of neoadjuvant therapy for pancreatic ductal adenocarcinoma. J. Surg. Oncol. 123, 1432–1440 (2021).

Article  CAS  PubMed  Google Scholar 

Oba, A. et al. Neoadjuvant treatment in pancreatic cancer. Front. Oncol. 10, 245 (2020).

Article  PubMed  PubMed Central  Google Scholar 

Ratnayake, B. et al. Recurrence patterns for pancreatic ductal adenocarcinoma after upfront resection versus resection following neoadjuvant therapy: a comprehensive meta-analysis. J. Clin. Med. 9, 2132 (2020).

Article  CAS  PubMed  PubMed Central  Google Scholar 

Sohal, D. P., Walsh, R. M., Ramanathan, R. K. & Khorana, A. A. Pancreatic adenocarcinoma: treating a systemic disease with systemic therapy. J. Natl Cancer Inst. 106, dju011 (2014).

Article  PubMed  Google Scholar 

Heinrich, S. et al. Opinions and use of neoadjuvant therapy for resectable, borderline resectable, and locally advanced pancreatic cancer: international survey and case-vignette study. BMC Cancer 19, 675 (2019).

Article  PubMed  PubMed Central  Google Scholar 

Reames, B. N. et al. Management of locally advanced pancreatic cancer: results of an international survey of current practice. Ann. Surg. 273, 1173–1181 (2021).

Article  PubMed  Google Scholar 

Khachfe, H. H., Habib, J. R., Nassour, I., Al Harthi, S. & Jamali, F. R. Borderline resectable and locally advanced pancreatic cancers: a review of definitions, diagnostics, strategies for treatment, and future directions. Pancreas 50, 1243–1249 (2021).

Article  PubMed  Google Scholar 

Takaori, K. et al. International Association of Pancreatology (IAP)/European Pancreatic Club (EPC) consensus review of guidelines for the treatment of pancreatic cancer. Pancreatology 16, 14–27 (2016).

Article  PubMed  Google Scholar 

Tempero, M. A. et al. Pancreatic Adenocarcinoma, Version 1.2022, NCCN Clinical Practice Guidelines in Oncology. National Comprehensive Cancer Network https://www.nccn.org/home (2022).

Vauthey, J. N. & Dixon, E. AHPBA/SSO/SSAT consensus conference on resectable and borderline resectable pancreatic cancer: rationale and overview of the conference. Ann. Surg. Oncol. 16, 1725–1726 (2009).

Article  PubMed  Google Scholar 

Das, P. et al. Pancreatic Adenocarcinoma. MD Anderson Cancer Center https://www.mdanderson.org/content/dam/mdanderson/documents/for-physicians/algorithms/cancer-treatment/ca-treatment-pancreatic-web-algorithm.pdf (2021).

Katz, M. H. G. et al. Borderline resectable pancreatic cancer: need for standardization and methods for optimal clinical trial design. Ann. Surg. Oncol. 20, 2787–2795 (2013).

Article  PubMed  PubMed Central  Google Scholar 

Japan Pancreas Society. General Rules for the Study of Pancreatic Cancer 7th edn (Kanehara & Co., Ltd, 2016).

Lutz, M. P. et al. Gallen EORTC gastrointestinal cancer conference: consensus recommendations on controversial issues in the primary tratment of pancreatic cancer. Eur. J. Cancer 79, 41–49 (2017).

Article  PubMed  Google Scholar 

Wu, Y. H. A. et al. Selecting surgical candidates with locally advanced pancreatic cancer: a review for modern pancreatology. J. Gastrointest. Oncol. 12, 2475–2483 (2021).

Article  PubMed  PubMed Central  Google Scholar 

Bratlie, S. O., Wennerblom, J., Vilhav, C., Persson, J. & Rangelova, E. Resectable, borderline, and locally advanced pancreatic cancer — “the good, the bad, and the ugly” candidates for surgery? J. Gastrointest. Oncol. 12, 2450–2460 (2021).

Article  PubMed  PubMed Central  Google Scholar 

Habib, J. R. & Wolfgang, C. L. Commentary: anatomic versus biologic resectability: the role of predictive biomarkers in guiding surgical management. Surgery 168, 1017–1018 (2020).

Article  PubMed  Google Scholar 

Khorana, A. A. et al. Potentially curable pancreatic cancer: american society of clinical oncology clinical practice guideline. J. Clin. Oncol. 34, 2541–2556 (2016).

Article  PubMed  Google Scholar 

Khorana, A. A. et al. Potentially curable pancreatic adenocaricnoma: ASCO clinical practice guideline update. J. Clin. Oncol. 37, 2082–2088 (2019).

Article  CAS  PubMed  Google Scholar 

Balaban, E. P. et al. Locally advanced, unresectable pancreatic cancer: american society of clinical oncology clinical practice guideline. J. Clin. Oncol. 34, 2654–2668 (2016).

Article  PubMed  Google Scholar 

Ducreux, M. et al. Cancer of the pancreas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 26, v56–v68 (2015).

Article  PubMed  Google Scholar 

Pentheroudakis, G., ESMO Guidelines Committee. Recent eUpdates to the ESMO Clinical Practice Guidelines on hepatocellular carcinoma, cancer of the pancreas, soft tissue and visceral sarcomas, cancer of the prostate and gastric cancer. Ann. Oncol. 30, 1395–1397 (2019).

Article  CAS  PubMed  Google Scholar 

Neuzillet, C. et al. Pancreatic cancer: French clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, ACHBT, AFC). Dig. Liver Dis. 50, 1257–1271 (2018).

Article  PubMed  Google Scholar 

Katz, M. H. G. et al. Borderline resectable pancreatic cancer: the importance of this emerging stage of disease. J. Am. Coll. Surg. 206, 833–848 (2008).

Article  PubMed  PubMed Central  Google Scholar 

Isaji, S. et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatology 18, 2–11 (2018).

Article  PubMed  Google Scholar 

Anger, F. et al. Impact of borderline resectability in pancreatic head cancer on patient survival: biology matters according to the new international consensus criteria. Ann. Surg. Oncol. 28, 2325–2336 (2021).

Article  PubMed  Google Scholar 

Tzeng, C. W. et al. Morbidity and mortality after pancreaticoduodenectomy in patients with borderline resectable type C clinical classification. J. Gastrointest. Surg. 18, 146–156 (2014).

Article  PubMed  Google Scholar 

Tsai, S. et al. Multimodality therapy in patients with borderline resectable or locally advanced pancreatic cancer: importance of locoregional therapies for a systemic disease. J. Oncol. Pract. 12, 915–923 (2016).

Article  PubMed  Google Scholar 

Chatzizacharias, N. A. et al. Locally advanced pancreas cancer: staging and goals of therapy. Surgery 163, 1053–1062 (2018).

Article  PubMed  Google Scholar 

Fromer, M. W. et al. An improved staging system for l