Or move in a clockwise fashion, the less chance for surgical resection. However, after neoadjuvant chemotherapy, the hope is for the patient's scores to move anticlockwise or drop below a score of 5, thereby increasing the chances of surgical resection. (B) “R” score criterion: the above graph indicates precision criteria based on perfusion and volumetrics. This R scoring criterion is truly based on 3D volumetrics and depicts that digit 5 is the game changer. Thus, a score of 5 and below predicts that the surgical intervention can be easily conducted as it can be determined that no major vessels will be involved, and the tumor will be highly perfused.
This is because the minor vessels have a less significant effect on the tumor and show fewer morphological aggressive changes compared to high perfusion areas. On the Spain phone number list other hand, a score of 6 and above clearly indicates the involvement of the major vessels such as celiac or hepatic thereby turning down the surgical candidacy. Moreover, the criteria of score 6 and above are also based on the involvement of major and minor tumor volume changes. Hence, if there is a major tumor volume change, the surgical procedure could have a better outcome when completed. If there is a minor tumor volume change, progression or regression status is critical; therefore, surgery cannot be completed.
Progression with a minor increase is a good indication for surgical candidacy but surgical candidacy in the case of regression with a minor change is based on the decision of the surgeon/oncologist. They either need to perform surgery or continue chemotherapy. Results A study of the administration of the neoadjuvant NABPLAGEM-NEO 2017 to 22 PDAC patients, was used to gauge the effectiveness of the Marley Equation and R scoring method on tumor resectability. A total of 27% of study participants (six of 22) had a positive response to the neoadjuvant therapy, as demonstrated by decreasing tumor volume in Table 2 and Figure 4. Notably, Patient 1 demonstrated complete remission.