Diagnostic and therapeutic approach to pancreatic adenocarcinoma

Pancreatic adenocarcinoma is the sixth leading cause of cancer-related death in Europe with survival rates remaining unchanged over the last three decades. Early diagnosis and accurate staging are essential due to the difficulty of curing this tumor in its advanced form. Endoscopic or laparoscopic ultrasonography and computed tomography are the preferred imaging and staging modalities for many patients with pancreatic adenocarcinoma. Morbidity and mortality are similar for pylorus-preserving and classic pancreatico-duodenectomy. Extended retroperitoneal lymphadenectomy does not improve survival and increases morbidity compared with standard pancreaticoduodenectomy, while adjuvant chemoradiotherapy prolongs survival in selected groups of patients. This article reviews the causes, risk factors, and clinical features of pancreatic adeno-carcinoma and discusses the methods of optimal diagnosis, staging and treatment.