{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:48:16Z","timestamp":1775044096125,"version":"3.50.1"},"reference-count":117,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Neoadjuvant therapy (NAT) is now central to the management of borderline resectable (BRPC) and locally advanced (LAPC) pancreatic ductal adenocarcinoma (PDAC). This narrative review summarizes contemporary evidence and guidelines from a surgical perspective, with emphasis on pretreatment classification, post-NAT selection for exploration, intraoperative vascular strategy, and postoperative management. Methods: We conducted a structured narrative review of randomized and prospective studies, high-quality observational cohorts, and major international guidelines published through 31 July 2025. Results: BRPC and LAPC remain primarily defined by vascular anatomy, but biologic and conditional factors are increasingly integrated into decision-making. NAT is the preferred initial strategy for BRPC and the standard induction approach for LAPC, with resection considered only in carefully selected responders. After NAT, contrast-enhanced CT combined with CA19-9 kinetics remains the core restaging platform, while FDG-PET, diffusion-weighted MRI, radiomics, and circulating biomarkers may serve as adjuncts in equivocal cases. Surgical exploration should be guided by physiologic recovery, the absence of metastatic progression, and multidisciplinary reassessment. Staging laparoscopy remains useful for detecting occult metastatic disease. Intraoperatively, vascular resection should be margin-driven rather than routine, with portal\u2013mesenteric venous resection established in expert centers, whereas arterial resection remains highly selective. Periarterial divestment represents an artery-sparing alternative in selected cases. NAT does not appear to worsen short-term postoperative outcomes, but anticoagulation after venous reconstruction remains non-standardized. Conclusions: NAT has transformed BRPC\/LAPC PDAC into a biology-gated, time-sequenced surgical pathway. Standardized reassessment, careful candidate selection, and the centralization of complex vascular procedures are essential to optimize outcomes.<\/jats:p>","DOI":"10.3390\/cancers18071131","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:09:21Z","timestamp":1775038161000},"page":"1131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Perspectives on Neoadjuvant Therapy in Borderline Resectable and Locally Advanced Pancreatic Cancer"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1284-1531","authenticated-orcid":false,"given":"Jingcheng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menghang","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helmut","family":"Friess","sequence":"additional","affiliation":[{"name":"Department of Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-1871","authenticated-orcid":false,"given":"Ihsan Ekin","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Scheufele","sequence":"additional","affiliation":[{"name":"Department of Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref_1","first-page":"10","article-title":"Cancer Statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","unstructured":"(2025, March 07). Krebs\u2014Cancer in Germany\u2014Cancer in Germany 2019\/2020. Available online: https:\/\/www.krebsdaten.de\/Krebs\/EN\/Content\/Publications\/Cancer_in_Germany\/cancer_in_germany.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41571-018-0112-1","article-title":"Optimizing the Outcomes of Pancreatic Cancer Surgery","volume":"16","author":"Strobel","year":"2019","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1001\/jama.2021.13027","article-title":"Pancreatic Cancer: A Review","volume":"326","author":"Park","year":"2021","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1097\/SLA.0000000000002234","article-title":"Patterns, Timing, and Predictors of Recurrence Following Pancreatectomy for Pancreatic Ductal Adenocarcinoma","volume":"267","author":"Groot","year":"2018","journal-title":"Ann. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/SLA.0000000000001731","article-title":"Pancreatic Cancer Surgery: The New R-Status Counts","volume":"265","author":"Strobel","year":"2017","journal-title":"Ann. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1038\/s41571-023-00746-1","article-title":"Neoadjuvant Therapy for Pancreatic Cancer","volume":"20","author":"Springfeld","year":"2023","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_8","unstructured":"(2025, March 07). Guidelines Detail. Available online: https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1455."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1245\/s10434-009-0408-6","article-title":"Pretreatment Assessment of Resectable and Borderline Resectable Pancreatic Cancer: Expert Consensus Statement","volume":"16","author":"Callery","year":"2009","journal-title":"Ann. Surg. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pan.2017.11.011","article-title":"International Consensus on Definition and Criteria of Borderline Resectable Pancreatic Ductal Adenocarcinoma 2017","volume":"18","author":"Isaji","year":"2018","journal-title":"Pancreatology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.annonc.2023.08.009","article-title":"Pancreatic Cancer: ESMO Clinical Practice Guideline for Diagnosis, Treatment and Follow-Up","volume":"34","author":"Conroy","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1200\/JCO.2017.72.4948","article-title":"Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update","volume":"35","author":"Khorana","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1200\/JCO.19.00946","article-title":"Potentially Curable Pancreatic Adenocarcinoma: ASCO Clinical Practice Guideline Update","volume":"37","author":"Khorana","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s10147-023-02317-x","article-title":"Clinical Practice Guidelines for Pancreatic Cancer 2022 from the Japan Pancreas Society: A Synopsis","volume":"28","author":"Okusaka","year":"2023","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_15","first-page":"205","article-title":"Chinese Society of Clinical Oncology (CSCO): Clinical Guidelines for the Diagnosis and Treatment of Pancreatic Cancer","volume":"2","author":"Cui","year":"2022","journal-title":"J. Natl. Cancer Cent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/SLA.0000000000002705","article-title":"Oncological Benefits of Neoadjuvant Chemoradiation With Gemcitabine Versus Upfront Surgery in Patients With Borderline Resectable Pancreatic Cancer: A Prospective, Randomized, Open-Label, Multicenter Phase 2\/3 Trial","volume":"268","author":"Jang","year":"2018","journal-title":"Ann. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1200\/JCO.19.02274","article-title":"Preoperative Chemoradiotherapy Versus Immediate Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Results of the Dutch Randomized Phase III PREOPANC Trial","volume":"38","author":"Versteijne","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S2468-1253(22)00348-X","article-title":"Immediate Surgery Compared with Short-Course Neoadjuvant Gemcitabine plus Capecitabine, FOLFIRINOX, or Chemoradiotherapy in Patients with Borderline Resectable Pancreatic Cancer (ESPAC5): A Four-Arm, Multicentre, Randomised, Phase 2 Trial","volume":"8","author":"Ghaneh","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1200\/JCO.21.02233","article-title":"Neoadjuvant Chemoradiotherapy Versus Upfront Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Long-Term Results of the Dutch Randomized PREOPANC Trial","volume":"40","author":"Versteijne","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"zrae172","DOI":"10.1093\/bjsopen\/zrae172","article-title":"Neoadjuvant Treatment versus Upfront Surgery in Borderline Resectable and Resectable Pancreatic Ductal Adenocarcinoma: Meta-Analysis","volume":"9","author":"Dickerson","year":"2025","journal-title":"BJS Open"},{"key":"ref_21","unstructured":"(2025, October 15). Nab-Paclitaxel Plus Gemcitabine in Patients with Locally Advanced Pancreatic Cancer (LAPACT): A Multicentre, Open-Label Phase 2 Study\u2014PubMed, Available online: https:\/\/pubmed.ncbi.nlm.nih.gov\/31953079\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/S2468-1253(20)30330-7","article-title":"Nab-Paclitaxel plus Gemcitabine versus Nab-Paclitaxel plus Gemcitabine Followed by FOLFIRINOX Induction Chemotherapy in Locally Advanced Pancreatic Cancer (NEOLAP-AIO-PAK-0113): A Multicentre, Randomised, Phase 2 Trial","volume":"6","author":"Kunzmann","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1093\/bjs\/znac354","article-title":"Surgical Resection Rates after Neoadjuvant Therapy for Localized Pancreatic Ductal Adenocarcinoma: Meta-Analysis","volume":"110","author":"Brown","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1002\/jhbp.12066","article-title":"Outcomes of Patients with Initially Unresectable Pancreatic Cancer Who Underwent Conversion Surgery after FOLFIRINOX or Gemcitabine plus Nab-paclitaxel Chemotherapy: A Multicenter Retrospective Cohort Study (PC-CURE-1)","volume":"31","author":"Okano","year":"2024","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1007\/s12094-024-03421-8","article-title":"Sarcopenia among Treated Cancer Patients before and after Neoadjuvant Chemotherapy: A Systematic Review and Meta-Analysis of High-Quality Studies","volume":"26","author":"Su","year":"2024","journal-title":"Clin. Transl. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1001\/jamasurg.2018.0979","article-title":"Association Between Changes in Body Composition and Neoadjuvant Treatment for Pancreatic Cancer","volume":"153","author":"Sandini","year":"2018","journal-title":"JAMA Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1245\/s10434-022-12985-0","article-title":"Change Impact of Body Composition During Neoadjuvant Chemoradiotherapy in Patients with Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma Undergoing Pancreatectomy","volume":"30","author":"Takaichi","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"570","DOI":"10.2214\/AJR.21.26931","article-title":"Imaging Assessment of Pancreatic Cancer Resectability After Neoadjuvant Therapy: AJR Expert Panel Narrative Review","volume":"218","author":"Soloff","year":"2022","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5609","DOI":"10.1007\/s00261-021-03284-5","article-title":"Can a Simplified CT Response Criteria for Vascular Involvement in Pancreatic Adenocarcinoma after Neoadjuvant Therapy Predict Survival in Patients Who Achieved Subsequent R0 Resection?","volume":"46","author":"Guo","year":"2021","journal-title":"Abdom. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3383","DOI":"10.1007\/s00330-020-07433-0","article-title":"CT in the Prediction of Margin-Negative Resection in Pancreatic Cancer Following Neoadjuvant Treatment: A Systematic Review and Meta-Analysis","volume":"31","author":"Park","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"110834","DOI":"10.1016\/j.ejrad.2023.110834","article-title":"Predictive Value of Computed Tomography on Surgical Resectability in Locally Advanced Pancreatic Cancer Treated with Multiagent Induction Chemotherapy: Results from a Prospective, Multicentre Phase 2 Trial (NEOLAP-AIO-PAK-0113)","volume":"163","author":"Guggenberger","year":"2023","journal-title":"Eur. J. Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/JP9.0000000000000156","article-title":"Modern Radiological Assessment after Neoadjuvant Therapy in Pancreatic Cancer: An Overview","volume":"7","author":"Moulla","year":"2024","journal-title":"J. Pancreatol."},{"key":"ref_33","first-page":"e52193","article-title":"Predicting Pathological Response to Preoperative Chemotherapy in Pancreatic Ductal Adenocarcinoma Using Post-Chemotherapy Computed Tomography Radiomics","volume":"16","author":"Ikuta","year":"2024","journal-title":"Cureus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.1245\/s10434-023-14805-5","article-title":"Delta Radiomic Features Predict Resection Margin Status and Overall Survival in Neoadjuvant-Treated Pancreatic Cancer Patients","volume":"31","author":"Wang","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/JP9.0000000000000148","article-title":"Computed Tomography-Based Delta Radiomics of Tumor Core_edge Combination for Systemic Treatment Response Evaluation in Pancreatic Cancer","volume":"7","author":"Li","year":"2024","journal-title":"J. Pancreatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.ijrobp.2022.09.084","article-title":"Predicting Treatment Response From Extracellular Volume Fraction for Chemoradiation Therapy of Pancreatic Cancer","volume":"115","author":"Noid","year":"2023","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s13244-023-01471-0","article-title":"Pancreatic CT Perfusion: Quantitative Meta-Analysis of Disease Discrimination, Protocol Development, and Effect of CT Parameters","volume":"14","author":"Skornitzke","year":"2023","journal-title":"Insights Imaging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1007\/s00330-023-10381-0","article-title":"Diffusion-Weighted Imaging for Determining Response to Neoadjuvant Therapy in Pancreatic Cancer: A Systematic Review and Meta-Analysis","volume":"34","author":"Bilreiro","year":"2024","journal-title":"Eur. Radiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"111893","DOI":"10.1016\/j.ejrad.2024.111893","article-title":"Multiparametric Quantitative Diffusion Weighted Magnetic Resonance Imaging Can Effectively Predict the Response to Neoadjuvant Therapy in Borderline Resectable Pancreatic Ductal Adenocarcinoma","volume":"183","author":"Qu","year":"2025","journal-title":"Eur. J. Radiol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Chen, Y., Ma, C., Yang, P., Mao, K., Gao, Y., Chen, L., Wang, Z., Bian, Y., Shao, C., and Lu, J. (2024). Values of Apparent Diffusion Coefficient in Pancreatic Cancer Patients Receiving Neoadjuvant Therapy. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-12934-y"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.6004\/jnccn.2022.7041","article-title":"FDG-PET Predicts Neoadjuvant Therapy Response and Survival in Borderline Resectable\/Locally Advanced Pancreatic Adenocarcinoma","volume":"20","author":"Abdelrahman","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40644-023-00565-8","article-title":"Post-Neoadjuvant Treatment Pancreatic Cancer Resectability and Outcome Prediction Using CT, 18F-FDG PET\/MRI and CA 19-9","volume":"23","author":"Yoo","year":"2023","journal-title":"Cancer Imaging"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1093\/jnci\/djae294","article-title":"Prognostic Factors in Localized Pancreatic Ductal Adenocarcinoma after Neoadjuvant Therapy and Resection: A Systematic Review and Meta-Analysis","volume":"117","author":"Javed","year":"2025","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.pan.2025.06.016","article-title":"Prognostic Impact of Post-Neoadjuvant CA19-9 Values in Pancreatic Cancer: More Pronounced Following Neoadjuvant Chemotherapy Compared to Neoadjuvant Chemoradiotherapy","volume":"25","author":"Miyahara","year":"2025","journal-title":"Pancreatology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e2400193","DOI":"10.1200\/PO.24.00193","article-title":"Development of a Composite Score Based on Carbohydrate Antigen 19-9 Dynamics to Predict Survival in Carbohydrate Antigen 19-9-Producing Patients With Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment","volume":"8","author":"Rompen","year":"2024","journal-title":"JCO Precis. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1097\/SLA.0000000000006021","article-title":"Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer: A Nationwide Multicenter Study","volume":"279","author":"Seelen","year":"2024","journal-title":"Ann. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"8906","DOI":"10.1245\/s10434-025-18084-0","article-title":"Favorable Response Defined by CA19-9 Reduction After Neoadjuvant Treatment for Pancreatic Cancer","volume":"35","author":"Ashitomi","year":"2025","journal-title":"Ann. Surg. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/j.surg.2024.06.049","article-title":"A Striking Elevation of CA19-9 after Preoperative Therapy Negates Prognostic Benefit from Radical Surgery in Resectable and Borderline Resectable Pancreatic Cancer","volume":"176","author":"Akita","year":"2024","journal-title":"Surgery"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.pan.2020.12.017","article-title":"Molecular Profiling of ctDNA in Pancreatic Cancer: Opportunities and Challenges for Clinical Application","volume":"21","author":"Sivapalan","year":"2021","journal-title":"Pancreatology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1245\/s10434-023-14751-2","article-title":"Initial Report: Personalized Circulating Tumor DNA and Survival in Patients with Resectable Pancreatic Cancer","volume":"31","author":"Eckhoff","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/SLA.0000000000001741","article-title":"Potential Biomarkers in Lewis Negative Patients With Pancreatic Cancer","volume":"265","author":"Luo","year":"2017","journal-title":"Ann. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Vitello, D.J., Shah, D., Wells, A., Masnyk, L., Cox, M., Janczewski, L.M., Abad, J., Dawravoo, K., D\u2019Souza, A., and Suh, G. (2024). Mutant KRAS in Circulating Tumor DNA as a Biomarker in Localized Pancreatic Cancer in Patients Treated with Neoadjuvant Chemotherapy. Ann. Surg., Advance online publication.","DOI":"10.1097\/SLA.0000000000006562"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"6501","DOI":"10.1245\/s10434-025-17433-3","article-title":"Elevated Carcinoembryonic Antigen Levels Predict Failure to Reach Surgery in Patients with Borderline Resectable Pancreatic Cancer Referred to Neoadjuvant Therapy","volume":"32","author":"Jacover","year":"2025","journal-title":"Ann. Surg. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/XCS.0000000000000704","article-title":"Yield of Staging Laparoscopy for Pancreatic Cancer in the Modern Era: Analysis of More than 1,000 Consecutive Patients","volume":"237","author":"Gudmundsdottir","year":"2023","journal-title":"J. Am. Coll. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.ejso.2022.12.011","article-title":"The Yield of Staging Laparoscopy for Resectable and Borderline Resectable Pancreatic Cancer in the PREOPANC Randomized Controlled Trial","volume":"49","author":"Versteijne","year":"2023","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jamcollsurg.2021.05.009","article-title":"Molecular Peritoneal Staging for Pancreatic Ductal Adenocarcinoma Using Mutant KRAS Droplet-Digital Polymerase Chain Reaction: Results of a Prospective Clinical Trial","volume":"233","author":"Yonkus","year":"2021","journal-title":"J. Am. Coll. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"4453","DOI":"10.1245\/s10434-025-17036-y","article-title":"Molecular KRAS ctDNA Predicts Metastases and Survival in Pancreatic Cancer: A Prospective Cohort Study","volume":"32","author":"Leiting","year":"2025","journal-title":"Ann. Surg. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1097\/MPA.0000000000000915","article-title":"Initial Features of Hepatic Metastases From Pancreatic Cancer: Histological and Radiolographical Appraisal of Hepatic Micrometastases Detected by Real-Time Fluorescent Imaging","volume":"46","author":"Katada","year":"2017","journal-title":"Pancreas"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2813","DOI":"10.1002\/cncr.26594","article-title":"Real-Time Detection of Hepatic Micrometastases from Pancreatic Cancer by Intraoperative Fluorescence Imaging: Preliminary Results of a Prospective Study","volume":"118","author":"Yokoyama","year":"2012","journal-title":"Cancer"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Roviello, F., Andreucci, E., Carbone, L., Calomino, N., Piccioni, S., Bobbio, L., Piagnerelli, R., Fontani, A., and Marrelli, D. (2025). Preoperative Injection of Indocyanine Green Fluorescence at the Anorectal Junction Safely Identifies the Inferior Mesenteric Artery in a Prospective Case-Series Analysis of Colorectal Cancer Patients. Gastrointest. Disord., 7.","DOI":"10.3390\/gidisord7040076"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.ejso.2017.04.016","article-title":"Long-Term Follow-up after near-Infrared Fluorescence-Guided Resection of Colorectal Liver Metastases: A Retrospective Multicenter Analysis","volume":"43","author":"Handgraaf","year":"2017","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"de Muynck, L.D.A.N., White, K.P., Alseidi, A., Bannone, E., Boni, L., Bouvet, M., Falconi, M., Fuchs, H.F., Ghadimi, M., and Gockel, I. (2023). Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons\u2019 Perspectives on Current Use and Future Recommendations. Cancers, 15.","DOI":"10.3390\/cancers15030652"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/SLA.0000000000005874","article-title":"The Revised R Status Is an Independent Predictor of Postresection Survival in Pancreatic Cancer After Neoadjuvant Treatment","volume":"279","author":"Leonhardt","year":"2024","journal-title":"Ann. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.surg.2014.02.001","article-title":"Borderline Resectable Pancreatic Cancer: A Consensus Statement by the International Study Group of Pancreatic Surgery (ISGPS)","volume":"155","author":"Bockhorn","year":"2014","journal-title":"Surgery"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/j.ejso.2023.03.229","article-title":"Pancreatectomy with Venous Vascular Resection for Pancreatic Cancer: Impact of Types of Vein Resection on Timing and Pattern of Recurrence","volume":"49","author":"Tamburrino","year":"2023","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e1291","DOI":"10.1097\/SLA.0000000000005444","article-title":"Portal Vein Resection in Pancreatic Cancer Surgery: Risk of Thrombosis and Radicality Determine Survival","volume":"277","author":"Hackert","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"7150","DOI":"10.1097\/JS9.0000000000002034","article-title":"Clinical Outcomes of Preservation versus Resection of Portal\/Superior Mesenteric Vein during Pancreaticoduodenectomy in Pancreatic Cancer Patients Who Respond to Neoadjuvant Treatment: A Retrospective Cohort Study","volume":"110","author":"Chae","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.surg.2020.07.054","article-title":"Mesoportal Bypass, Interposition Graft, and Mesocaval Shunt: Surgical Strategies to Overcome Superior Mesenteric Vein Involvement in Pancreatic Cancer","volume":"168","author":"Habib","year":"2020","journal-title":"Surgery"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jviscsurg.2024.04.003","article-title":"Mesenteric and Portal Venous Resections during Pancreatoduodenectomy","volume":"161","author":"Vaillant","year":"2024","journal-title":"J. Visc. Surg."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1007\/s00423-025-03745-1","article-title":"Standardization of Surgical Procedure for Initially Unresectable Locally Advanced Pancreatic Head Cancer","volume":"410","author":"Sumiyoshi","year":"2025","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.surg.2020.04.033","article-title":"The Left Splenorenal Venous Shunt Decreases Clinical Signs of Sinistral Portal Hypertension Associated with Splenic Vein Ligation during Pancreaticoduodenectomy with Venous Resection","volume":"168","author":"Addeo","year":"2020","journal-title":"Surgery"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"101540","DOI":"10.1016\/j.jvscit.2024.101540","article-title":"Temporary Mesenteric Venous Shunting for Portal Vein Reconstruction: A Novel Technical Adjunct","volume":"10","author":"Quatromoni","year":"2024","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Libia, A., Marchese, T., D\u2019Ugo, S., Piscitelli, P., Castellana, F., Clodoveo, M.L., Zupo, R., and Spampinato, M.G. (2024). Use of Vascular Shunt at the Time of Pancreatectomy with Venous Resection: A Systematic Review. Cancers, 16.","DOI":"10.3390\/cancers16132361"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Heckler, M., Abdallah, S., Kinny-K\u00f6ster, B., Berchtold, C., Al-Saeedi, M., Mehrabi, A., Hackert, T., Hinz, U., Hank, T., and Michalski, C.W. (2025). Temporary Portal Vein Bypass for Resection of Pancreatic Neoplasms. Ann. Surg., ahead of print.","DOI":"10.1097\/SLA.0000000000006662"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/s00423-025-03826-1","article-title":"How-I-Do-It: Meso-Caval Shunt: A Safe Emergency Option for Venous Reconstruction in Pancreaticoduodenectomy","volume":"410","author":"Wei","year":"2025","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"rjaf624","DOI":"10.1093\/jscr\/rjaf624","article-title":"Pancreatectomy with En Bloc Superior Mesenteric Vein Resection and Permanent Mesocaval Shunting for Locally Advanced Pancreatic Head Cancer","volume":"2025","author":"Fujii","year":"2025","journal-title":"J. Surg. Case Rep."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00423-024-03446-1","article-title":"Pancreatoduodenectomy with Superior Mesenteric Vein Resection and Non-Reconstruction for Pancreatic Head Cancer Paying Particular Attention to Hemodynamics","volume":"409","author":"Sugitani","year":"2024","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1097\/SLA.0000000000006248","article-title":"REDISCOVER International Guidelines on the Perioperative Care of Surgical Patients With Borderline-Resectable and Locally Advanced Pancreatic Cancer","volume":"280","author":"Boggi","year":"2024","journal-title":"Ann. Surg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/bjs\/znac353","article-title":"Pancreatectomy with Arterial Resection for Periampullary Cancer: Outcomes after Planned or Unplanned Events in a Nationwide, Multicentre Cohort","volume":"110","author":"Stoop","year":"2023","journal-title":"Br. J. Surg."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/j.surg.2020.11.030","article-title":"Not All Whipple Procedures Are Equal: Proposal for a Classification of Pancreatoduodenectomies","volume":"169","author":"Mihaljevic","year":"2021","journal-title":"Surgery"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jamcollsurg.2018.05.001","article-title":"Indications and Perioperative Outcomes for Pancreatectomy with Arterial Resection","volume":"227","author":"Tee","year":"2018","journal-title":"J. Am. Coll. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Noel, C., Azeez, A., Du Preez, A., and Noel, K. (2025). Arterial Resections in Pancreatic Cancer-An Updated Systematic Review and Meta-Analysis. Cancers, 17.","DOI":"10.3390\/cancers17091540"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1097\/SLA.0000000000004054","article-title":"Arterial Resection in Pancreatic Cancer Surgery: Effective After a Learning Curve","volume":"275","author":"Loos","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"6111","DOI":"10.1097\/JS9.0000000000000971","article-title":"Postoperative Results, Learning Curve, and Outcomes of Pancreatectomy with Arterial Resection: A Single-Center Retrospective Cohort Study on 236 Procedures","volume":"110","author":"Napoli","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.surg.2020.08.030","article-title":"Periarterial Divestment in Pancreatic Cancer Surgery","volume":"169","author":"Diener","year":"2021","journal-title":"Surgery"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.sopen.2023.03.001","article-title":"Technical Options in Surgery for Artery-Involving Pancreatic Cancer: Invasion Depth Matters","volume":"12","author":"Miao","year":"2023","journal-title":"Surg. Open Sci."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s00423-021-02080-5","article-title":"Sub-Adventitial Divestment Technique for Resecting Artery-Involved Pancreatic Cancer: A Retrospective Cohort Study","volume":"406","author":"Cai","year":"2021","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"109045","DOI":"10.1016\/j.surg.2024.109045","article-title":"Periarterial Divestment Following Neoadjuvant Therapy in Patients with Locally Advanced Pancreatic Cancer with Celiac Axis Invasion: A Safe and Effective Surgical Procedure","volume":"180","author":"Fu","year":"2025","journal-title":"Surgery"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"109412","DOI":"10.1016\/j.surg.2025.109412","article-title":"Periarterial Divestment for Borderline and Locally Advanced Pancreatic Cancer: An Analysis of 125 Cases in a Single Center","volume":"184","author":"Yang","year":"2025","journal-title":"Surgery"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/jamasurg.2020.5676","article-title":"Contemporary Reappraisal of Intraoperative Neck Margin Assessment During Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Review","volume":"156","author":"Datta","year":"2021","journal-title":"JAMA Surg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1097\/SLA.0000000000000890","article-title":"Value of Intraoperative Neck Margin Analysis during Whipple for Pancreatic Adenocarcinoma: A Multicenter Analysis of 1399 Patients","volume":"260","author":"Kooby","year":"2014","journal-title":"Ann. Surg."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1097\/SLA.0000000000003503","article-title":"Revision of Pancreatic Neck Margins Based on Intraoperative Frozen Section Analysis Is Associated With Improved Survival in Patients Undergoing Pancreatectomy for Ductal Adenocarcinoma","volume":"274","author":"Zhang","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"6211","DOI":"10.1245\/s10434-020-09568-2","article-title":"What Should Guide the Performance of Venous Resection During Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma with Venous Contact?","volume":"28","author":"Navez","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.pan.2018.04.010","article-title":"Pathology Assessment of Pancreatic Cancer Following Neoadjuvant Treatment: Time to Move On","volume":"18","author":"Verbeke","year":"2018","journal-title":"Pancreatology"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.pan.2024.12.008","article-title":"Frozen Section Analysis of Pancreatic Resection Margins during Pancreaticoduodenectomy for Pancreatic Adenocarcinoma Is Not Affected by Neoadjuvant Therapy","volume":"25","author":"Ibrahim","year":"2025","journal-title":"Pancreatology"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"6004","DOI":"10.1245\/s10434-022-11804-w","article-title":"Intraoperative Pancreatic Neck Margin Assessment During Pancreaticoduodenectomy for Pancreatic Adenocarcinoma in the Era of Neoadjuvant Therapy: A Multi-Institutional Analysis from the Central Pancreatic Consortium","volume":"29","author":"Kelly","year":"2022","journal-title":"Ann. Surg. Oncol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.amjsurg.2013.01.015","article-title":"Examining the Accuracy and Clinical Usefulness of Intraoperative Frozen Section Analysis in the Management of Pancreatic Lesions","volume":"205","author":"Nelson","year":"2013","journal-title":"Am. J. Surg."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/13651820701278273","article-title":"A Novel Approach to the Intraoperative Assessment of the Uncinate Margin of the Pancreaticoduodenectomy Specimen","volume":"9","author":"Khalifa","year":"2007","journal-title":"HPB"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.5858\/arpa.2023-0359-RA","article-title":"Intraoperative Frozen Section Evaluation of Pancreatic Specimens and Related Liver Lesions","volume":"149","author":"Vazzano","year":"2025","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"3810","DOI":"10.1245\/s10434-020-09460-z","article-title":"Neoadjuvant Therapy for Pancreatic Ductal Adenocarcinoma: Propensity-Matched Analysis of Postoperative Complications Using ACS-NSQIP","volume":"28","author":"Krell","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1177\/00031348221087900","article-title":"Comparing Post-Operative Outcomes of Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: Neoadjuvant Therapy Versus Surgery First Approach","volume":"88","author":"Hyman","year":"2022","journal-title":"Am. Surg."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1097\/XCS.0000000000000971","article-title":"Impact of Neoadjuvant Therapy for Pancreatic Cancer: Transatlantic Trend and Postoperative Outcomes Analysis","volume":"238","author":"Davis","year":"2024","journal-title":"J. Am. Coll. Surg."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1016\/j.surg.2024.01.029","article-title":"Preoperative Chemoradiotherapy but Not Chemotherapy Is Associated with Reduced Risk of Postoperative Pancreatic Fistula after Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Nationwide Analysis","volume":"175","author":"Wismans","year":"2024","journal-title":"Surgery"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.hpb.2021.04.027","article-title":"The Effect of Preoperative Chemotherapy and Chemoradiotherapy on Pancreatic Fistula and Other Surgical Complications after Pancreatic Resection: A Systematic Review and Meta-Analysis of Comparative Studies","volume":"23","author":"Wismans","year":"2021","journal-title":"HPB"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"109552","DOI":"10.1016\/j.surg.2025.109552","article-title":"Impact of Neoadjuvant Therapy on Short-Term Outcomes after Left Pancreatectomy: A Propensity Score-Matched International Multicenter Study","volume":"185","author":"Bonsdorff","year":"2025","journal-title":"Surgery"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1111\/ans.15885","article-title":"Impact of Neoadjuvant Therapy on Post-Operative Pancreatic Fistula: A Systematic Review and Meta-Analysis","volume":"90","author":"Kamarajah","year":"2020","journal-title":"ANZ J. Surg."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1245\/s10434-023-14763-y","article-title":"Neoadjuvant Chemotherapy Is Associated with Increased Risk of Postoperative DVT After Distal Pancreatectomy for Pancreatic Adenocarcinoma: A NSQIP Analysis","volume":"31","author":"Robbins","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.hpb.2021.12.010","article-title":"AHPBA Guidelines for Managing VTE Prophylaxis and Anticoagulation for Pancreatic Surgery","volume":"24","author":"Clancy","year":"2022","journal-title":"HPB"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1470-2045(22)00160-7","article-title":"2022 International Clinical Practice Guidelines for the Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer, Including Patients with COVID-19","volume":"23","author":"Farge","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annonc.2022.12.014","article-title":"Venous Thromboembolism in Cancer Patients: ESMO Clinical Practice Guideline","volume":"34","author":"Falanga","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.23.00294","article-title":"Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Guideline Update","volume":"41","author":"Key","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1007\/s00268-020-05462-w","article-title":"Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019","volume":"44","author":"Melloul","year":"2020","journal-title":"World J. Surg."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"423","DOI":"10.14701\/ahbps.23-065","article-title":"Anticoagulation after Pancreatic Surgery with Venous Resection (TIGRESS): What Should We Do? Results from an International Survey","volume":"27","author":"Russell","year":"2023","journal-title":"Ann. Hepatobiliary Pancreat. Surg."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"101852","DOI":"10.1016\/j.gassur.2024.10.007","article-title":"Thrombosis and Anticoagulation after Portal Vein Reconstruction during Pancreatic Surgery: A Systematic Review","volume":"29","author":"Heckler","year":"2025","journal-title":"J. Gastrointest. Surg."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"5771","DOI":"10.1097\/JS9.0000000000001755","article-title":"Comparison of Patency Rates and Complications with or without Antithrombotic Therapy Following Portal Vein Stent Placement after Pancreatic Surgery: A Systematic Review and Meta-Analysis","volume":"110","author":"Chen","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Labib, P.L., McKay, S.C., Perrodin, S.F., Bolm, L., Mownah, O.A., Bellotti, R., McClements, J., Sultana, A., Skipworth, J.R., and Balakrishnan, A. (2025). Anticoagulation Practice and Risk of Portal Vein Thrombosis Following Pancreaticoduodenectomy or Total Pancreatectomy with Venous Resection: An International Multicentre Cohort Study. Ann. Surg., Advance online publication.","DOI":"10.1016\/j.hpb.2025.07.175"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1016\/j.hpb.2022.06.005","article-title":"Patency Rates of Hepatic Arterial Resection and Revascularization in Locally Advanced Pancreatic Cancer","volume":"24","author":"Abdelrahman","year":"2022","journal-title":"HPB"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/7\/1131\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:21:29Z","timestamp":1775038889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/7\/1131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":117,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["cancers18071131"],"URL":"https:\/\/doi.org\/10.3390\/cancers18071131","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}