eP454 Reviewing outcomes and management of Borderline Resectable Pancreatic Cancer in a Local Hepatobiliary Centre

Aims The role of neoadjuvant chemotherapy in treating Borderline Resectable Pancreatic Cancer (BRPC) has been defined and supported by trials. This study aims to assess the outcomes of patients with BRPC who undergo neoadjuvant chemotherapy and those who undergo upfront surgery. Methods Patients with BRPC from January 2020 – January 2023 were retrospectively identified from regional multidisciplinary team records. Patients unfit for surgery or who declined surgery were excluded. Data were extracted from electronic patient records. Key outcomes included progression of disease, progression to surgery, resectability, survival, and postoperative complications. Results 21 patients were included, 12 male and 9 female. 20 patients were planned for surgery after neoadjuvant chemotherapy. 4 patients (20.0%) did not progress to start treatment, 3 (15.0%) did not progress to surgery, and 4 resections were abandoned after exploratory laparotomies (20.0%). 9 patients (45.0%) progressed to tumour resection; 4 with R0 margins and 5 with R1 margins. The progression-free survival ranged from 6 months to 50 months (uncensored), excluding 1 postoperative death within 30 days. The two-year overall survival rate was 50%. 1 patient had upfront surgery and a progression-free survival of 12 months with overall survival of 18 months. Conclusion Due to the limited sample size, comparative analysis between subgroups could not be performed, and overall survival data were not censored. Outcomes in patients who underwent neoadjuvant Chemotherapy are aligned with research trials. This study also highlighted potential delays within the treatment pathway, identifying the need for a standardised, centralised protocol to optimise patient management.