Pancreatic Cancer Staging: Identifying Surgical Candidates

Resectability is the central question

For pancreatic adenocarcinoma, the single most consequential staging decision is whether the tumor is resectable. This depends on involvement of the superior mesenteric vein, portal vein, and arterial structures.

Staging informs sequencing

• Resectable disease proceeds to surgery, often followed by adjuvant therapy.
• Borderline resectable may benefit from neoadjuvant therapy to improve margins.
• Locally advanced / metastatic is managed primarily with systemic treatment.

A structured tumor board helps align surgical, medical, and radiation perspectives before committing to a path.