Summary

• Fourth most common cause of cancer-related death in the US.
• Most common presentation is at 65 to 75 years of age with painless obstructive jaundice and weight loss. Generally presents late with advanced disease.
• Surgical resection offers the only hope for cure. Chemotherapy and radiotherapy, as primary treatment modalities, produce a small but statistically significant benefit. Adjuvant chemotherapy prolongs survival.
• Only a minority (5% to 10%) of patients can undergo potentially curative surgery: these patients have a 5-year survival of up to 22%, which decreases to <2% in the presence of distant metastasis .
• Patients with metastatic disease (50% to 55%) have a limited survival of only 3 to 6 months.