Advances in diagnosis and treatment of pancreatic cancer.

This review focuses on key advances in diagnosis and treatment of pancreatic cancer, with a particular emphasis on the expanding potential application of molecular techniques and the great strides made in evolving safe pancreatic resection. The epidemiology of pancreatic cancer is reviewed, and recent advances for potential screening are reported. Improvements in operative morbidity and mortality following pancreatic resection have led to calls for more radical surgery, and the results of conventional and extended radical surgery are compared. Recently combined multimodality adjuvant therapy has been used following "curative resection" for pancreatic cancer, and the current status concerning use of this treatment is addressed. Although there is insufficient evidence to recommend routine use of adjuvant therapy, there are sufficient encouraging data to advocate entering patients in large, adjuvant therapy trials. In addition to safe resectional surgery, advances in novel molecular therapy mean that the outlook for patients with pancreatic cancer should no longer be considered hopeless.