Ann Surg Oncol (2009) 16:1725–1726
DOI 10.1245/s10434-009-0409-5
ORIGINAL ARTICLE – CONSENSUS REPORT: RESECTABLE AND BORDERLINE RESECTABLE PANCREAS CANCER
AHPBA/SSO/SSAT Consensus Conference on Resectable
and Borderline Resectable Pancreatic Cancer: Rationale
and Overview of the Conference
Jean-Nicolas Vauthey, MD1 and Elijah Dixon, MD2
1
Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, Houston, TX;
2
Department of Surgery, Division of Surgical Oncology, University of Calgary, Calgary, AB, Canada
On January 24, 2008, the American Hepato-Pancreato-
Biliary Association convened a Consensus Conference on
Resectable and Borderline Resectable Pancreatic Cancer.
The conference was cosponsored by the Society of Surgical
Oncology, the Society for Surgery of the Alimentary Tract,
The University of Texas M. D. Anderson Cancer Center,
and the Gastrointestinal Symposium Steering Committee.
The goals of this conference were to define resectable and
borderline resectable pancreatic cancer and to review the
indications and contraindications for surgery, neoadjuvant
therapy, and adjuvant therapy for these lesions. The
meeting took place over 1 day and was divided into three
sessions addressing (1) pretreatment assessment, (2) sur-
gical treatment, and (3) combined-modality treatment.
This issue of Annals of Surgical Oncology has three
articles outlining the consensus statements, each accom-
panied by an editorial. The methods used in this consensus
conference have been described previously.1 After con-
sultation among experts from the three sponsoring
societies, a group of experts was identified and invited to
participate in this conference. Each expert was asked to
present on a given area and to outline two or three con-
sensus statements at the end of his or her presentation. A
panel of content experts commented on the consensus
statements, and then the audience was given the opportu-
nity to comment on the consensus statements. After the
symposium, three manuscripts, each summarizing one of
the sessions, were written by the speakers and session
Ó Society of Surgical Oncology 2009
First Received: 3 October 2008;
Published Online: 24 April 2009
J.-N. Vauthey, MD
e-mail: jvauthey@mdanderson.org
cochairs. Each manuscript was then given to the corre-
sponding session panelists, who wrote a brief editorial
highlighting areas of controversy and importance and
providing alternative perspectives.
The consensus statements define ‘‘resectable’’ and
‘‘borderline resectable.’’ This important first step provides
a starting point for discussion regarding the appropriate
use of surgery, neoadjuvant therapy, and adjuvant ther-
apy. Use of consistent definitions of resectable and
borderline resectable will facilitate comparison between
institutions and future published works, which currently
is limited because of the variety of definitions used in the
published literature dealing with pancreatic cancer. The
consensus statements also highlight the acceptable
methods of radiologic and endoscopic assessment of
resectable and borderline resectable pancreatic tumors,
the clinical settings in which preoperative biopsy is
needed, and the specific indications for the selective use
of laparoscopic staging. Further, the consensus statements
recommend against extended lymphadenectomy, define
the clinical setting in which vascular reconstruction may
be necessary, and recommend that operating surgeons
have facility with these techniques. There is also a call
for standardized margin definitions and a description of
the limited role of ‘‘palliative’’ pancreaticoduodenectomy.
The consensus statements identify the clinical setting in
which before-surgery systemic therapy and radiation
therapy may be warranted and highlight the conflict-
ing evidence regarding postoperative chemotherapy alone
versus combined chemoradiotherapy. Finally, areas
requiring further study are identified and highlighted.
The conference participants and the consensus state-
ments generated reflect the importance of ongoing
collaborative multidisciplinary care of patients with pan-
creatic cancer.
1726 J.-N. Vauthey, E. Dixon

REFERENCE overview of the conference. January 25, 2006. Ann Surg Oncol.
2006;13:1259–60.
1. Vauthey JN, Choti MA, Helton WS. AHPBA/SSO/SSAT consen-
sus conference on hepatic colorectal metastases: rationale and