ASCO GUIDELINES Bundle

Potentially Curable Pancreatic Adenocarcinoma

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Treatment Recommendation 1.4 ➤ Multidisciplinary collaboration to formulate treatment and care plans and disease management for patients with potentially curable pancreatic cancer should be the standard of care. (Strong Recommendation; EB-B-I) Recommendation 1.5 ➤ Every person with pancreatic cancer should be offered information about clinical trials, including therapeutic trials in all lines of treatment, as well as palliative care, biorepository/biomarker, and observational studies. (Strong Recommendation; IC-B-I) Recommendation 2.1 ➤ Primary surgical resection of the primary tumor and regional lymph nodes is recommended for patients with potentially curable pancreatic cancer who meet all of the following criteria: no clinical evidence for metastatic disease, a performance status and comorbidity profile appropriate for a major abdominal operation, no radiographic interface between primary tumor and mesenteric vasculature on high-definition cross-sectional imaging, and a CA 19-9 level (in absence of jaundice) suggestive of potentially curable disease. (Strong Recommendation; EB-B-I) Recommendation 3.1 ➤ Preoperative therapy is recommended for patients with pancreatic cancer who meet any of the following criteria: radiographic findings suspicious but not diagnostic for extrapancreatic disease, a performance status or comorbidity profile not currently appropriate (but potentially reversible) for a major abdominal operation, a radiographic interface between primary tumor and mesenteric vasculature on cross-sectional imaging that does not meet appropriate criteria for primary resection, or a CA 19-9 level (in absence of jaundice) suggestive of disseminated disease. (Strong Recommendation; EB-B-L) Recommendation 3.2 ➤ Preoperative therapy should be offered as an alternative treatment strategy for any patient who meets all criteria in 2.1. (Strong Recommendation; EB-B-L)

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