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, 378 (9791), 607-20

Pancreatic Cancer


Pancreatic Cancer

Audrey Vincent et al. Lancet.


Substantial progress has been made in our understanding of the biology of pancreatic cancer, and advances in patients' management have also taken place. Evidence is beginning to show that screening first-degree relatives of individuals with several family members affected by pancreatic cancer can identify non-invasive precursors of this malignant disease. The incidence of and number of deaths caused by pancreatic tumours have been gradually rising, even as incidence and mortality of other common cancers have been declining. Despite developments in detection and management of pancreatic cancer, only about 4% of patients will live 5 years after diagnosis. Survival is better for those with malignant disease localised to the pancreas, because surgical resection at present offers the only chance of cure. Unfortunately, 80-85% of patients present with advanced unresectable disease. Furthermore, pancreatic cancer responds poorly to most chemotherapeutic agents. Hence, we need to understand the biological mechanisms that contribute to development and progression of pancreatic tumours. In this Seminar we will discuss the most common and deadly form of pancreatic cancer, pancreatic ductal adenocarcinoma.

Conflict of interest statement

Conflicts of interest

RHH and MG have a licensing agreement with Myriad Genetics for genetic testing of PALB2 as a pancreatic cancer susceptibility gene. All other authors declare that they have no conflicts of interest.


Figure 1
Figure 1. Histological features of pancreatic intraepithelial neoplasia
(A–D) Magnification x??.
Figure 2
Figure 2. PanIN progression model, showing genetic alterations
PanIN=pancreatic intraepithelial neoplasia. Reprinted from ref , with permission of the American Association for Cancer Research.
Figure 3
Figure 3. Cross-sectional imaging and analysis of an intraductal papillary mucinous neoplasm
(A) CT. (B) ??. (C) Endoscopic ultrasound. (D) Histological analysis (magnification x??). (E) Resected tumour.

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