Benjamin PT Loveday1, Lara Lipton2, Benjamin NJ Thomson3. 1. MBChB, PhD, FRACS, Hepatopancreatobiliary Surgeon, Department of Surgery, Royal Melbourne Hospital, Vic; Hepatopancreatobiliary Surgeon, Department of Surgical Oncology, Peter MacCallum Cancer Centre, Vic; Senior Lecturer, Department of Surgery, University of Auckland, NZ. 2. MBBS, PhD, FRACP, Medical Oncologist, Department of Medical Oncology, Peter MacCallum Cancer Centre, Vic; Medical Oncologist, Department of Medical Oncology, Cabrini Health, Vic; Associate Professor, University of Melbourne, Vic. 3. MBBS, DMedSci, FRACS, Hepatopancreatobiliary Surgeon, Department of Surgery, Royal Melbourne Hospital, Vic; Hepatopancreatobiliary Surgeon, Department of Surgical Oncology, Peter MacCallum Cancer Centre, Vic; Associate Professor, University of Melbourne, Vic.
Abstract
BACKGROUND: Pancreatic cancer has the highest mortality rate among all main cancer types and is the fourth leading cause of cancer death in Australia. OBJECTIVE: This review focuses on the 95% of pancreatic cancers that arise as pancreatic ductal adenocarcinoma, with the aim to summarise current recommendations for diagnosis and treatment. DISCUSSION: No cardinal symptoms for pancreatic cancer exist. Weight loss combined with abdominal symptoms or back pain in individuals aged ≥60 years prompts urgent computed tomography of the abdomen, while individuals aged ≥40 years with jaundice require direct specialist referral. Pancreatic cancer is categorised as resectable, borderline resectable, locally advanced or metastatic. Resectable disease is treated with surgical resection and adjuvant chemotherapy. Borderline resectable and locally advanced disease are treated with neoadjuvant therapy, followed by surgical exploration if the disease is non-progressive. Metastatic and unresectable disease is treated with chemotherapy or best supportive care. Nutritional support is required for most patients.
BACKGROUND:Pancreatic cancer has the highest mortality rate among all main cancer types and is the fourth leading cause of cancer death in Australia. OBJECTIVE: This review focuses on the 95% of pancreatic cancers that arise as pancreatic ductal adenocarcinoma, with the aim to summarise current recommendations for diagnosis and treatment. DISCUSSION: No cardinal symptoms for pancreatic cancer exist. Weight loss combined with abdominal symptoms or back pain in individuals aged ≥60 years prompts urgent computed tomography of the abdomen, while individuals aged ≥40 years with jaundice require direct specialist referral. Pancreatic cancer is categorised as resectable, borderline resectable, locally advanced or metastatic. Resectable disease is treated with surgical resection and adjuvant chemotherapy. Borderline resectable and locally advanced disease are treated with neoadjuvant therapy, followed by surgical exploration if the disease is non-progressive. Metastatic and unresectable disease is treated with chemotherapy or best supportive care. Nutritional support is required for most patients.
Authors: Zhan Shi; Ju Yang; Weiwei Kong; Xin Qiu; Changchang Lu; Juan Liu; Baorui Liu; Juan Du Journal: Front Oncol Date: 2022-03-01 Impact factor: 6.244