[Pancreatic cancer]

Pancreatic cancer Abstract. Pancreatic cancer is the second most common cancer in the GI tract in Europe and North America and it is associated with a poor prognosis due to its aggressive tumor biology. Each year the number of deaths from pancreatic cancer is almost the same as the number of new cases diagnosed. Most of the pancreatic cancers develop from exocrine cells, while endocrine pancreatic cancers (i. e., neuroendocrine tumors or islet cell tumors) are uncommon. The term "pancreatic cancer" is typically used to refer to pancreatic adenocarcinoma, which will be the focus of this paper. Despite the introduction of multimodal therapy concepts, advanced surgical techniques, and increasing surgical specialization, overall survival in pancreatic cancer has not significantly improved. Early and complete surgical tumor resection remains the only curative option; however, this is rarely achieved, mainly due to the advanced stage at diagnosis. Adjuvant chemotherapy has become the gold standard after upfront resection. Neoadjuvant chemotherapy regimens, such as FOLFIRINOX, represent a valid option in order to achieve complete surgical tumor resection in more advanced cases. However, the overall uptake of this promising concept is very low.