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44

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

5

Treatment guide

Borderline resectable pancreatic cancer

Guide 10

shows the follow-up tests and treatments

recommended after completing neoadjuvant

treatment for borderline resectable pancreatic

cancer. Follow-up tests are given after treatment to

check how well treatment worked and to make sure

there has been no cancer growth or spread.

Tests

Repeat imaging tests such as a CT or MRI of your

abdomen, pelvis, and chest are recommended. The

most common test is a pancreatic protocol CT scan,

similar to what was done prior to starting treatment.

You may also have a staging laparoscopy.

Test results and primary treatment

If the follow-up tests don’t show any signs of

cancer growth or spread, then you will proceed with

an operation to remove the tumor. There are 3 types

of surgery for pancreatic cancer. Which type of sur-

gery you will have depends on the size and location

of the cancer in your pancreas. The types of surgery

are listed in Part 3.

Guide 10. Follow-up after neoadjuvant treatment

Tests

Test results

Further treatment

• Pancreaitc

protocol CT or

MRI (abdomen

and pelvis)

• Chest CT

(preferred) or

x-ray

• CA 19-9 taken

after treatment

ª

• No cancer

growth or

spread-

Consider

staging

laparoscopy

before surgery

ª

• Surgery

ª

• Complete surgery

ª

Surgery is not an option:

• If jaundice,

consider

biliary bypass with

or without duodenal

bypass, with or without

nerve block for pain

• If no jaundice,

seek

treatment for locally

advanced unresectable

or metastatic

pancreatic cancer

ª

• Cancer growth

or spread-

Surgery is not

an option

ª

• Seek treatment for locally advanced

unresectable or metastatic pancreatic cancer