To comment on the observation about doing neoadjuvent chemo even though the tumor was small, unlike other solid tumor types, pancreatic cancer is the one results in metastatic disease much sooner. In my 12 years as a survivor, I have seen many cases where the tumor was stage I, surgery was performed and restaged with metastatic disease within 2 years. Having a Whipple or distal pancreatectomy with splenectomy is half the equation.

Just this morning I was reading about a study done at Yale from 2014-2021 using Folfirinox in the neoadjuvant setting being beneficial. It was published in the Journal of the American Medical Association-Oncology.