Ricerc@Sapienza

Pancreatic cancer is a leading cause of cancer-related death worldwide, and its burden is destined to increase. Multimodal treatment is crucial to achieve a cure, but standardization is far to come. Borderline resectable disease is the most challenging situation to face. An anatomically resectable disease may hide a biologically aggressive or undiagnosed systemic disease. Whether the patient has to undergo surgery first or after locoregional or systemic therapy is still unknown. Decision-making stands on low-quality evidences since RCTs are lacking.

Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms. About 40-80% of patients with PNET are metastatic at presentation, usually involving the liver (40-93%). Liver metastasis represents the most significant prognostic factor. The aim of this study is to present an up-to-date review of treatment options for patients with liver metastases from PNETs.

Background: In literature, percentages of pathologic complete response (pCR) in patients presenting with resectable (RES), borderline resectable (BLR) or locally advanced (LA) pancreatic cancer (PaC) after neoadjuvant treatment (NADT) are variable, ranging 0–33%. Those data come mostly from retrospective reviews of single centres. The objective of this systematic review is to assess the incidence of pCR. Methods: Following the criteria of the PRISMA statement, a literature search was conducted looking for prospective papers focusing on neoadjuvant treatment in PaC.