Pancreatic cancer
Abstract
Pancreatic cancer is a highly lethal disease, for which mortality closely parallels incidence. Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage. There is no standard programme for screening patients at high risk of pancreatic cancer (eg, those with a family history of pancreatic cancer and chronic pancreatitis). Most pancreatic cancers arise from microscopic non-invasive epithelial proliferations within the pancreatic ducts, referred to as pancreatic intraepithelial neoplasias. There are four major driver genes for pancreatic cancer: KRAS, CDKN2A, TP53, and SMAD4. KRAS mutation and alterations in CDKN2A are early events in pancreatic tumorigenesis. Endoscopic ultrasonography and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer. Surgical resection is regarded as the only potentially curative treatment, and adjuvant chemotherapy with gemcitabine or S-1, an oral fluoropyrimidine derivative, is given after surgery. FOLFIRINOX (fluorouracil, folinic acid [leucovorin], irinotecan, and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) are the treatments of choice for patients who are not surgical candidates but have good performance status.
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The overall survival at 5-years for pancreatic cancer is 6-10%, due in large part to late diagnosis which precludes curative resections.
“The overall survival at 5-years is 6–10%, due in large part to late diagnosis which precludes curative resections [1, 2].”
From Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer (2023) · cites this paper as [1]
Even for pancreatic cancer patients who received resection, the overall 5-year survival rate is less than 25% because of early recurrence.
“Even for patients who received resection, the overall 5-year survival rate is less than 25% because of early recurrence [1, 2].”
From Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer (2023) · cites this paper as [1]
Pancreatic ductal adenocarcinoma is usually found after it has reached an advanced stage, which limits treatment options and contributes to poor survival.
“Pancreatic ductal adenocarcinoma is most frequently detected at an advanced stage. Such late detection restricts treatment options and contributes to a dismal 5-year survival rate of 3–15%.”
From Early detection of pancreatic cancer (2020) · cites this paper as [5]
PDAC is a disease with near-uniform mortality.
“Pancreatic ductal adenocarcinoma (PDAC) is a disease of near uniform mortality”
From Tumor Microbiome Diversity and Composition Influence Pancreatic Cancer Outcomes (2019) · cites this paper as Kamisawa et al., 2016
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- Authors
- Kamisawa, T., Wood, L. D., Itoi, T., & Takaori, K.
- Affiliations
- Tokyo Metropolitan Komagome Hospital (JP)
- Johns Hopkins University (US)
- Tokyo Medical University (JP)
- Kyoto University (JP)
- Corresponding author
- Kamisawa, Terumi
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 388
- Issue
- 10039
- Pages
- 73-85
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4210976084
- Cited by
- 2,212
- References
- 11
- Citations by year
- 2026: 80 · 2025: 139 · 2024: 204 · 2023: 231 · 2022: 271 · 2021: 314 · 2020: 360 · 2019: 272 · 2018: 184 · 2017: 133 · 2016: 22
- FWCI
- 20.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
- Keywords
- pancreatic cancer, pancreatic intraepithelial neoplasia, KRAS mutation, CDKN2A, TP53, SMAD4, pancreatic carcinogenesis, endoscopic ultrasound, endoscopic ultrasound-guided fine-needle aspiration, pancreatic cancer screening, surgical resection, adjuvant chemotherapy, gemcitabine, S-1, FOLFIRINOX, nab-paclitaxel, advanced pancreatic cancer
- MeSH terms
- Irinotecan, Oxaliplatin, Gemcitabine, Albumins, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Carcinoembryonic Antigen, Leucovorin, Deoxycytidine, Fluorouracil, Humans, Organoplatinum Compounds, Pancreatectomy, Pancreatic Neoplasms, Tumor Suppressor Protein p53, Proto-Oncogene Proteins p21(ras), Paclitaxel, Neoplasms, Cystic, Mucinous, and Serous, CA-19-9 Antigen, Endosonography, Genes, p16, Carcinoma, Pancreatic Ductal, Smad4 Protein, Endoscopic Ultrasound-Guided Fine Needle Aspiration
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