Introduction: Portal Vein Embolization (PVE) is gold standard strategy to increase Future Liver Remnant (FLR) at level of Kinetic Growth Rate (KGR) about 2.3 cc/day and prevent posthepatectomy liver failure (PHLF) in patients to underwent major liver resections. Up to 30% of patients with liver malignances still couldn't underwent surgery after PVE due to tumor progression and/or insufficient FLR regeneration during waiting period. Currently there are no methods that resolve both mentioned issues. Method: Six initially unresectable, due to small FLR, patients with colorectal liver metastases (CRLM), in close proximity to FLR critical structures (portal and/or hepatocaval confluence), having more than three criteria of Fong Clinical Risk Score for CRLM were approved by Ethical Comitee for Simultaneous PVE and Transarterial Chemoembolization with Degradable Starch Microspheres (DSM-TACE). For those patients, SIMULTA-NEOUSLY with standard PVE, was performed

Background: Borderline pancreatic adenocarcinoma (BPAC) may be technically resectable with high risks of R1 resection and postoperative recurrence. Neoadjuvant chemotherapy (NAC) is used without clear consensus. We present the preliminary Results of multidisciplinary management of BPAC patients Methods: We adopted the definition of the National Comprehensive Cancer Network (NCCN) for BPAC. All patients received neoadjuvant chemotherapy with at minimum 4 cures. The goal of this study was to investigate the morbidity and survival after surgical resection depending on the quality of oncological resection. Results: From September 2012 to December 2018,120 patients underwent pancreaticoduodenectomy (PD) for adenocarcinoma of the head of the pancreas. Among them, 34 (28%) had BPAC. Vascular resection was performed in 32% of patient. R0 resection was achieved in 56% of cases and R1 in 44%. According to surgical margin, R1 resections were divided into R1 0mm (54%) and R1 low ]0,1 mm[ (46%) Ninety-day mortality was nil. A pancreatic fistula occurred in 6% of patients. In terms of survival, overall (p=0.71) and recurrence-free (P=0.32) survival were similar to those in patients with resectable tumors. Same findings were noted between R0 et R1 low (p=0.72). Survival was statistically lower in the group R1 0mm when compared to survival of R0 group (P=0.05). Conclusions: Using a multidisciplinary approach to manage BPAC, good outcome could be achieved. Oncological quality of resection with at least R1 low resection is of paramount importance to ensure optimal survival.