Is it possible to predict resectability in pancreatic cancers? A retrospective study in a tertiary center

Objectives: Pre-operative radiological or laboratory evaluations can provide some insight into resectability in pancreatic ductal adenocarcinoma (PDAC). However, these methods still fall short, as patients may be deemed unresectable during perioperative exploration. Our study seeks to identify novel predictors that can accurately determine the resectability status of PDAC patients. Methods: Patients who underwent surgical exploration for potentially resectable PDAC were retrospectively analyzed and categorized into two groups: resectable and unresectable during exploration. Univariate and multivariate analyses were employed to predict resectability based on the identified predictors. Results: Out of the 120 patients who underwent surgical exploration, 30 (25%) were found to be unresectable during the surgical procedure. Multivariate analysis disclosed that tumor size ≥ 4 cm, carbohydrate antigen (CA) 19-9 > 500 U/mL, and lymphocyte count ≤ 1.55 × 103/uL (p = 0.013, 0.014, 0.031, respectively) were associated with non-resectability. Conclusions: Tumor size, CA 19-9 levels, and lymphopenia have correlations with unresectability in PDAC patients. These factors can be valuable in preoperatively predicting the presence of an unresectable tumor.