[Resectability evaluation in pancreatic cancer].

Area of Science:

• Oncology
• Radiology
• Gastroenterology

Context:

• Pancreatic cancer staging is critical for treatment planning and patient selection for curative resection.
• Accurate loco-regional and distant staging impacts surgical candidacy and overall prognosis.
• Multimodality imaging plays a pivotal role in assessing resectability.

Purpose:

• To review the current imaging modalities used for staging pancreatic cancer.
• To highlight the complementary roles of various imaging techniques in determining resectability.
• To discuss the utility of advanced imaging in identifying metastatic disease.

Summary:

• Multidetector computed tomography (MDCT) is the primary imaging modality for assessing loco-regional and distal resectability.
• Endoscopic ultrasonography (EUS) aids in staging small tumors and guiding lymph node biopsies.
• Magnetic resonance imaging (MRI) with MR angiography evaluates vascular involvement, while laparoscopy with ultrasound helps avoid unnecessary laparotomy.
• Positron emission tomography (PET) is being evaluated for detecting occult metastatic disease.

Impact:

• Optimized patient selection for pancreatic cancer surgery.
• Improved accuracy in determining surgical resectability.
• Reduced unnecessary surgical interventions through precise staging.
• Potential for earlier detection of metastatic pancreatic cancer.