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Pancreatic Adenocarcinoma

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Surgical Oncology

Abstract

Pancreatic ductal adenocarcinoma is the most common and most aggressive form of pancreatic cancer. A solid exocrine tumor arising from the pancreatic ducts, it comprises approximately 90 % of all solid tumors of the pancreas. Pancreatic adenocarcinoma develops from precursor lesions such as pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasia (IPMN), and mucinous cystic neoplasm (MCN). Progression is thought to involve telomere shortening and mutations of the oncogene KRAS occurring in early stages, followed by the inactivation of the p16 tumor suppressor gene in the intermediate stages and, finally, the inactivation of the p53, SMAD4 (DPC4), and BRCA-2 tumor suppressor genes at late stages. The diagnosis of pancreatic adenocarcinoma remains challenging owing to the lack of adequate screening techniques. This leads to the majority of pancreatic adenocarcinoma being diagnosed in late stages. Among the cancers diagnosed in earlier stages, the best chance at cure involves multimodality treatment strategies that include surgical resection and chemotherapy and radiation. Ultimately, due to the aggressive natural history of the disease, many patients require palliative treatments.

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Authors and Affiliations

  1. Department of Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, 01605, Worcester, MA, USA

    Jillian K. Smith M.D., M.P.H.

  2. Department of Surgery, LSU Health Sciences Center-Shreveport, 1501 Kings Hwy, 33932, 71130-3932, Shreveport, LA, USA

    Quyen D. Chu M.D., M.B.A, F.A.C.S.

  3. Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Stoneman 913, 02459, Boston, MA, USA

    Jennifer F. Tseng M.D., M.P.H.

Authors
  1. Jillian K. Smith M.D., M.P.H.
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  2. Quyen D. Chu M.D., M.B.A, F.A.C.S.
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  3. Jennifer F. Tseng M.D., M.P.H.
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Correspondence to Jennifer F. Tseng M.D., M.P.H. .

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Editors and Affiliations

  1. Department of Surgery, LSU Health Sciences Center-Shreveport, Shreveport, Louisiana, USA

    Quyen D. Chu

  2. Department of Surgery, Jersey Shore University Medical Center, Neptune, New Jersey, USA

    John F. Gibbs

  3. John C. McDonald Regional Transplant Center, Willis Knighton Health System, Shreveport, Louisiana, USA

    Gazi B. Zibari

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Smith, J.K., Chu, Q.D., Tseng, J.F. (2015). Pancreatic Adenocarcinoma. In: Chu, Q., Gibbs, J., Zibari, G. (eds) Surgical Oncology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1423-4_13

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  • DOI: https://doi.org/10.1007/978-1-4939-1423-4_13

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