Abstract
There are two distinct types of pancreatic cancer, differentiated by whether they arise from exocrine or endocrine tissue. By far the most common (up to 95 %) are neoplasms of the exocrine pancreas, and they are the focus of this discussion. Most exocrine pancreatic neoplasms (90 %) are adenocarcinomas, and three quarters of them arise in the head of the pancreas. Neoplasms of the endocrine pancreas are relatively rare and differ both biologically and clinically from exocrine cancers. Because they affect endocrine tissue, they often cause recognizable hormonal symptoms; thus, they are often detected at early stages and are more successfully treated. Exocrine pancreatic cancers, in contrast, do not cause early symptoms, and when symptoms appear, they are often vague in nature. By the time significant pain, jaundice, or weight loss is evaluated, disease is usually advanced, and as many as 80 % of patients present with disease defined as regionally advanced or metastatic on imaging studies.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Altekruse SF, Kosary CL, Krapcho M, et al., editors. SEER Cancer Statistics Review, 1975–2007. National Cancer Institute; 2010. http://seer.cancer.gov/csr/1975_2007/, based on November 2009 SEER data submission, posted to the SEER Web site. Accessed 23 May 2012.
Tempero MA, Arnoletti JP, Behrman SW. Pancreatic Adenocarcinoma, Version 2.2012 Updates to the NCCN Guidelines. J Natl Compr Canc Netw. 2012 Jun 1;10(6):703–13.
Varadhachary GR, Tamm EP, Abbruzzese JL, et al. Borderline resectable pancreatic cancer: definitions, management, and role of preoperative therapy. Ann Surg Oncol. 2006;13(8):1035–46.
National Cancer Institute Pancreatic Cancer Treatment (PDQ®), Health Professional Version. http://www.cancer.gov. Updated 5 March 2010. Accessed 22 May 2012.
Fernández-del Castillo C, Rattner DW, Warshaw AL. Standards for pancreatic resection in the 1990s. Arch Surg. 1995 Mar;130(3):295–9; discussion 299–300.
Kalser MH, Ellenberg SS. Pancreatic cancer: adjuvant combined radiation and chemotherapy following curative resection. Arch Surg. 1985;120:899–903.
Burris III HA, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15:2403–13.
Gourgou-Bourgade S, de la Fouchardière C, Bennouna J, et al. Groupe Tumeurs Digestives of Unicancer; PRODIGE Intergroup. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25.
Katz MH, Wang H, Fleming JB, et al. Long-term survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol. 2009;16(4):836–47.
Raut CP, Tseng JF, Sun CC, et al. Impact of resection status on pattern of failure and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Ann Surg. 2007;246(1):52–60.
Hwang RF, Moore T, Arumugam T, et al. Cancer-associated stromal fibroblasts promote pancreatic tumor progression. Cancer Res. 2008;68(3):918–26.
Olive KP, Jacobetz MA, Davidson CJ, et al. Inhibition of Hedgehog signaling enhances delivery of chemotherapy in a mouse model of pancreatic cancer. Science. 2009;324(5933):1457–61.
Hwang RF, Wang H, Lara A, et al. Development of an integrated biospecimen bank and multidisciplinary clinical database for pancreatic cancer. Ann Surg Oncol. 2008;15(5):1356–66.
Kim MP, Evans DB, Wang H, Abbruzzese JL, Fleming JB, Gallick GE. Generation of orthotopic and heterotopic human pancreatic cancer xenografts in immunodeficient mice. Nat Protoc. 2009;4(11):1670–80.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Fleming, J., Katz, M., Hwang, R., Varadhachary, G. (2013). Pancreatic Cancer (Exocrine). In: Rodriguez, M., Walters, R., Burke, T. (eds) 60 Years of Survival Outcomes at The University of Texas MD Anderson Cancer Center. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5197-6_12
Download citation
DOI: https://doi.org/10.1007/978-1-4614-5197-6_12
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-5196-9
Online ISBN: 978-1-4614-5197-6
eBook Packages: MedicineMedicine (R0)