Hepato-biliary and pancreatic (HPB) malignancies are the leading cause of death, and the frequency of these diseases is rising. Regretfully, the majority of patients with HPB malignancies are not eligible for upfront curative treatment at the time of diagnosis due to locally progressed or systemic disease. Moreover, a sizeable percentage of patients who have had their cancer surgically removed will face an early recurrence. Novel therapeutic multimodal strategies, such as neoadjuvant and per-operative therapy, are therefore becoming increasingly popular because of their ability to increase overall and recurrence-free survival and to increase the number of patients who are sensitive to curative treatments.
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