Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes

This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, pr...

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Published in	World journal of gastroenterology : WJG Vol. 24; no. 43; pp. 4846 - 4861
Main Authors	McGuigan, Andrew, Kelly, Paul, Turkington, Richard C, Jones, Claire, Coleman, Helen G, McCain, R Stephen
Format	Journal Article
Language	English
Published	United States Baishideng Publishing Group Inc 21.11.2018
Subjects	Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor - analysis Carcinoma, Pancreatic Ductal - diagnosis Carcinoma, Pancreatic Ductal - epidemiology Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - therapy Chemoradiotherapy, Adjuvant - methods Early Detection of Cancer - methods Humans Incidence Mass Screening - methods Neoadjuvant Therapy - methods Pancreas - pathology Pancreas - surgery Pancreatectomy - methods Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - pathology Pancreatic Neoplasms - therapy Precancerous Conditions - diagnosis Precancerous Conditions - epidemiology Precancerous Conditions - pathology Prognosis Quality of Life Review Risk Factors Survival Rate Treatment Outcome Pancreatic adenocarcinoma Pancreatic cancer treatment Pancreatic cancer Pancreatic cancer risk factors
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Abstract	This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites.
AbstractList	This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites. This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites.This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites.
Author	McCain, R Stephen Kelly, Paul Turkington, Richard C Jones, Claire Coleman, Helen G McGuigan, Andrew
Author_xml	– sequence: 1 givenname: Andrew surname: McGuigan fullname: McGuigan, Andrew – sequence: 2 givenname: Paul surname: Kelly fullname: Kelly, Paul – sequence: 3 givenname: Richard C surname: Turkington fullname: Turkington, Richard C – sequence: 4 givenname: Claire surname: Jones fullname: Jones, Claire – sequence: 5 givenname: Helen G surname: Coleman fullname: Coleman, Helen G – sequence: 6 givenname: R Stephen surname: McCain fullname: McCain, R Stephen
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/30487695$$D View this record in MEDLINE/PubMed
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Copyright	The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. 2018
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Keywords	Pancreatic adenocarcinoma Pancreatic cancer treatment Pancreatic cancer Pancreatic cancer risk factors
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 Author contributions: McGuigan A, Turkington RC, Coleman HG, McCain RS designed research; McGuigan A, Kelly P, McCain RS performed research; McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG and McCain RS all wrote the paper. Correspondence to: R Stephen McCain, BM, BCh, Surgeon, Centre for Public Health, Royal Victoria Hospital, Block B, Belfast BT12 6BA, United Kingdom. smccain02@qub.ac.uk Telephone: +44-28-90635009 Fax: +44-28-90235900
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SubjectTerms	Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor - analysis Carcinoma, Pancreatic Ductal - diagnosis Carcinoma, Pancreatic Ductal - epidemiology Carcinoma, Pancreatic Ductal - pathology Carcinoma, Pancreatic Ductal - therapy Chemoradiotherapy, Adjuvant - methods Early Detection of Cancer - methods Humans Incidence Mass Screening - methods Neoadjuvant Therapy - methods Pancreas - pathology Pancreas - surgery Pancreatectomy - methods Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - pathology Pancreatic Neoplasms - therapy Precancerous Conditions - diagnosis Precancerous Conditions - epidemiology Precancerous Conditions - pathology Prognosis Quality of Life Review Risk Factors Survival Rate Treatment Outcome
Title	Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes
URI	https://www.ncbi.nlm.nih.gov/pubmed/30487695 https://www.proquest.com/docview/2139567138 https://pubmed.ncbi.nlm.nih.gov/PMC6250924
Volume	24
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