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Invited Commentary
July 24, 2019

Neoadjuvant Therapy of Pancreatic Ductal Adenocarcinoma With Vascular Involvement Shows Promise

Author Affiliations
  • 1Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles
JAMA Surg. 2019;154(10):942. doi:10.1001/jamasurg.2019.2278

Although pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy, incremental progress has been realized over the past decade with new chemotherapeutic regimens, advanced surgical techniques, and an improved understanding of genetics. Although most patients are not candidates for surgical resection because of metastatic disease, many centers are focused on offering curative treatment for patients with borderline resectable (BR) or locally advanced (LA) tumors. These patients are treated with chemotherapy and radiation up front followed by surgical resection, and surgery often includes the resection and reconstruction of major blood vessels. In a prospective observational study, Maggino et al1 report the utility of primary chemotherapy for BR and LA PDAC along with the rates of receipt and completion of therapy, conversion to operation, and survival.

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