Complete Pathological Response to Neoadjuvant Treatment in Pancreatic Ductal Adenocarcinoma-Can We Achieve a Long-Term Survival? A Narrative Review.

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer-related mortality in Europe, with a 5-year survival rate of approximately 10%. Surgical intervention is the only curative method of treatment in PDAC. However, especially in the case of patients with borderline or locally advanced cancer, neoadjuvant treatment is often administered in an attempt to downstage the tumor. Uncommonly, after neoadjuvant treatment, no viable tumor in the specimen after surgical resection is found- this is defined as a complete pathological response (pCR). Our paper presents a narrative review of this rare phenomenon and its possible association with patient's survival. Conclusions: Achieving pCR may be associated with a significant improvement in the prognosis of patients with PDAC. However, it remains unknown why pCR is achievable in only a few patients. Further studies on large groups of patients are needed to identify the factors that increase the chance of pCR.