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46

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

5

Treatment guide

Borderline resectable pancreatic cancer

Guide 11

shows the tests and treatments

recommended after surgery for borderline resectable

pancreatic cancer. This is referred to as adjuvant

treatment, which refers to treatment given after

surgical resection to try to kill any remaining cancer

cells.

Tests

Before beginning adjuvant treatment, you will have a

CT scan of the abdomen with contrast and CA 19-9

blood test. Contrast is a dye that is put into the body

to make clearer pictures during imaging tests. These

tests are done to check for signs of cancer that has

returned, grown, or spread.

Test results

If the tests don’t show any signs of recurrence or

metastases, the next treatment recommendations

depend on whether or not you had neoadjuvant

treatment before surgery.

If you did not have neoadjuvant treatment, then you

will be recommended to receive adjuvant treatment.

Adjuvant treatment should only be started after

you’ve fully recovered from surgery. Starting 4 to 8

weeks after surgery is ideal.

If you had neoadjuvant treatment, then your doctor

may still want to give you adjuvant treatment,

depending on what kind of and how much treatment

you received before surgery, and what was found

during the surgery.

Guide 11. Adjuvant treatment after surgery

Tests

Tests results

Adjuvant treatment Follow-up

• Abdomen

CT with

contrast

• CA 19-9

ª

• No neoadjuvant

treatment,

no recurrence

or metastatic

disease

ª

• Clinical trial

(preferred)

or

• Chemotherapy alone

or

• Chemotherapy, then

chemoradiation,

possibly followed by

more chemotherapy

ª

ª

Surveillance

every 3 to 6

months for 2

years, then every

6 to 12 months

with:

• Medical history

and physical

exam

• CA19-9

• Abdomen

CT scan with

contrast

ª

• Had

neoadjuvant

treatment,

no recurrence

or metastatic

disease

ª

• Consider more

chemotherapy

ª

• Metastatic

disease

ª

• See treatment for metastatic disease