Pancreatic cancer
Treatment options in Shanghai

Send the original contrast-enhanced CT or MRI series, the report and examination date. A sentence saying “vascular involvement” is not a complete surgical assessment: the reviewing clinicians need to identify the vessel, extent of tumour contact and whether safe removal and reconstruction appear feasible. They must also assess disease elsewhere. Ask whether the existing scan answers these questions or whether updated, appropriately performed imaging is needed. A clear explanation of the anatomical obstacle is more useful than a yes-or-no promise about surgery based only on a translated report.

For some people, treatment before surgery, commonly chemotherapy and sometimes chemoradiation, is considered to address disease and improve the prospects of a later operation. It also creates a point at which the team can reassess the cancer and the person’s ability to tolerate surgery. This does not mean every borderline case follows the same regimen. Ask what supports the proposed sequence, what alternatives were discussed, and whether tissue confirmation or additional staging is required before starting. Do not interrupt existing treatment while awaiting an overseas opinion without discussing the timing with the treating team.

For borderline resectable pancreatic cancer, the greatest value is a shared treatment map across surgery, imaging and oncology. The pancreatic and hepatobiliary team at Fudan University Shanghai Cancer Center brings together surgeons, pathologists, medical and radiation oncologists, imaging specialists and endoscopists. A Shanghai review can clarify the vessel involvement, the reason for treatment before surgery and the criteria for reconsidering an operation.