| Category |
Criteria |
| Resectable |
No distant metastases
No evidence of SMV and portal vein abutment, distortion, tumor thrombus or venous encasement
Clear fat planes around the celiac axis, hepatic artery, and SMA. |
| Borderline
resectable |
No distant metastases
Venous involvement of the SMV/portal vein demonstrating tumor abutment with or without impingement and narrowing of the lumen, encasement of the SMV/portal vein but without encasement of the nearby arteries, or short segment venous occlusion resulting from either tumor thrombus or encasement but with suitable vessel proximal and distal to the area of vessel involvement, allowing for safe resection and reconstruction.
Gastroduodenal artery encasement up to the hepatic artery with either short segment encasement or direct abutment of the hepatic artery, without extension to the celiac axis.
Tumor abutment of the SMA not to exceed 180 degrees of the circumference of the vessel wall |
Abbreviations: SMA- Superior Mesenteric Artery; SMV- Superior Mesenteric Vein |
