Pancreatic cancer

Pancreatic cancer is the sixth most common cause of cancer-related death in Europe.

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.

'Pancreatic cancer' refers to primary pancreatic ductal adenocarcinoma, which accounts for >85% of all pancreatic neoplasms. The course of pancreatic cancer has been shown to follow a linear progression model from pre-invasive pancreatic intraepithelial neoplastic lesions to invasive ductal adenocarcinoma. Two additional well-defined precursor lesions are the intraductal papillary mucinous neoplasm and the mucinous cystic neoplasm.[1]Maitra A, Hruban RH. Pancreatic cancer. Annu Rev Pathol. 2008;3:157-88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2666336 http://www.ncbi.nlm.nih.gov/pubmed/18039136?tool=bestpractice.com