OnCo
termsTerm

Resectable, borderline resectable and unresectable

aka resectable, resectability, unresectable, non-resectable, inoperable, operable, borderline resectable, borderline-resectable, potentially resectable, initially unresectable, upfront surgery, upfront resection, conversion to resectability, conversion surgery, downstaged

The surgeon's verdict on whether the tumour can be completely removed. Resectable means yes; unresectable means it has wrapped around vital vessels, is too extensive or the patient is too frail; borderline means maybe, especially after chemotherapy shrinks it.

Resectability is judged on imaging by involvement of arteries and veins (pancreatic cancer's borderline definitions concern the superior mesenteric vessels), extent of nodal disease (N2-3 in lung cancer) and liver remnant volume, and is not the same as stage: some stage IV colorectal liver metastases are resectable and some stage II pancreatic tumours are not. Unresectable does not mean incurable: stage III lung cancer is cured by chemoradiation plus durvalumab in a third of patients, and 'conversion therapy' (FOLFOXIRI-bevacizumab in liver metastases, RAS inhibitors in pancreatic cancer) turns some unresectable cancers into resectable ones. Multidisciplinary review is required because surgeons differ in what they will attempt.

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Treatment jargon

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