[Diagnosing pancreatic cancer]

Pancreatic adenocarcinoma represents a major public health challenge. Symptoms may vary according to tumor location: painless jaundice for head tumors (80-90%), transfixing epigastric pain for body tumors, and general condition deterioration for tail tumors. Multiphase pancreatic-protocol computed tomography scan constitutes the reference examination, supplemented when necessary, by endoscopic ultrasound with fine-needle aspiration/biopsy and hepatic MRI. The NCCN classification distinguishes four categories based on vascular relationships: resectable (10%), borderline (10%), locally advanced (30%), and metastatic (50%), determining the therapeutic strategy. The recent integration of biological criteria (CA19-9) and clinical parameters with anatomical assessment (ABC classification) enables better selection of surgical candidates.