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Adenocarcinoma of the Pancreas

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Surgical Oncology Manual

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Abstract

Pancreatic cancer is the fifth leading cause of cancer death in Canada with slowly rising incidence and projections to become the second cause of cancer death by 2020. Diagnosis is based on history and physical examination, laboratory and imaging studies including computed tomography (CT). Tissue diagnosis is needed only to offer chemotherapy in unresectable cases and when neoadjuvant chemotherapy is considered. Stage at diagnosis is the most important prognostic factor and depends on careful evaluation of the CT to assess resectability. Overall survival of patients with resectable disease is ~30 % at 5 years. However, only 15–20 % of cases are resectable at diagnosis. Commonly observed metastatic sites include liver, peritoneum, and lung. Treatment of pancreatic cancer depends on the stage of disease. Surgery is the only curative treatment for localized disease. Completeness of resection (R0) is prognostically important. Adjuvant chemotherapy is currently recommended as standard of care.

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Authors and Affiliations

  1. Hepatopancreatobiliary Surgery, University of Toronto, Toronto, ON, Canada

    Amélie Tremblay St-Germain M.D., F.R.C.S.C.

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Steven Gallinger M.D., M.Sc., F.R.C.S.C., Paul J. Karanicolas M.D., Ph.D., F.R.C.S.C. & Carol-anne E. Moulton M.D., Ph.D., F.R.A.C.S.

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  1. Amélie Tremblay St-Germain M.D., F.R.C.S.C.
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  2. Steven Gallinger M.D., M.Sc., F.R.C.S.C.
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  3. Paul J. Karanicolas M.D., Ph.D., F.R.C.S.C.
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  4. Carol-anne E. Moulton M.D., Ph.D., F.R.A.C.S.
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Correspondence to Amélie Tremblay St-Germain M.D., F.R.C.S.C. .

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Editors and Affiliations

  1. Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Frances C. Wright

  2. Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Jaime Escallon

  3. Department of Surgical Oncology, National Cancer Institute, Panama City, Panama

    Moises Cukier

  4. General Surgical Oncology, University of Toronto, 1X5, Ontario, Canada

    Melanie E. Tsang

  5. General Surgical Oncology, University of Toronto, Toronto, Ontario, Canada

    Usmaan Hameed

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© 2016 University of Toronto General Surgery Oncology Program

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Tremblay St-Germain, A., Gallinger, S., Karanicolas, P.J., Moulton, Ca.E. (2016). Adenocarcinoma of the Pancreas. In: Wright, F., Escallon, J., Cukier, M., Tsang, M., Hameed, U. (eds) Surgical Oncology Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-26276-5_19

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