Imaging diagnosis of pancreatic cancer: A state-of-the-art review

Lee, Eun Sun; Lee, Jeong Min

doi:10.3748/wjg.v20.i24.7864

Cited by 321 publications

(257 citation statements)

References 112 publications

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“…Pancreatic cancer remains one of the deadliest cancers worldwide with a poor, five-year survival rate of 5% [10]. To improve the patient survival rate, early detection of pancreatic cancer is of vital importance.…”

Section: Discussionmentioning

confidence: 99%

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Screening for Subsequent Pancreatic Cancer in Childhood Cancer Survivors is Needed. A Case Report

Zadravec-Zaletel¹,

Cavlek²,

Gjidera³

2017

J Nucl Med Radiat Ther

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Introduction: The survival of children with cancer has improved considerably over the last decades which have led to a growing number of long term survivors. One of the most serious adverse outcomes in this population is subsequent primary neoplasms with the risk as high as six-fold over expected. The relative risk for subsequent pancreatic cancer in childhood cancer survivors is high, especially after subdiafragmatic radiotherapy and/or chemotherapy with alkylating agents. The survival of patient with advanced pancreatic cancer is very low, and early diagnosis is of vital importance.

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Section: Discussionmentioning

confidence: 99%

“…A lower relative risk (3.6) of SPC was reported in adult patients with testicular cancer [9]. The survival of patients with advanced pancreatic cancer is very low, and early diagnosis is of vital importance [10]. To our knowledge no guidelines exist for the screening of pancreatic cancer in CCS who are at high risk for SPC.…”

Section: Introductionmentioning

confidence: 99%

Screening for Subsequent Pancreatic Cancer in Childhood Cancer Survivors is Needed. A Case Report

Zadravec-Zaletel¹,

Cavlek²,

Gjidera³

2017

J Nucl Med Radiat Ther

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“…Magnetic Resonance Imaging (MRI) is capable of providing staging information similar to that from a CT scan and can be performed in patients with allergies to CT contrast with the added advantage of cholangiopancreatography (MRCP) [57] to aid in delineating the anatomy of the biliary tree and the pancreatic duct in addition to contrast enhanced magnetic resonance angiography to show vascular invasion. At present, MRI for pancreatic cancer staging is generally limited to instances in which patients cannot receive CT contrast, because it offers no other major advantages over CT and is a more expensive imaging modality [57].…”

Section: Imaging Evaluationsmentioning

confidence: 99%

“…At present, MRI for pancreatic cancer staging is generally limited to instances in which patients cannot receive CT contrast, because it offers no other major advantages over CT and is a more expensive imaging modality [57].…”

Section: Imaging Evaluationsmentioning

confidence: 99%

“…All of this information can improve the prediction of resectability. When evaluating a patient for operation, the following criteria are used to determine potential resectability: (1) no evidence of extrapancreatic or distant metastatic disease, (2) patency of the PV and SMV confluence, and (3) no involvement of the celiac axis or SMA [56].Magnetic Resonance Imaging (MRI) is capable of providing staging information similar to that from a CT scan and can be performed in patients with allergies to CT contrast with the added advantage of cholangiopancreatography (MRCP) [57] to aid in delineating the anatomy of the biliary tree and the pancreatic duct in addition to contrast enhanced magnetic resonance angiography to show vascular invasion. At present, MRI for pancreatic cancer staging is generally limited to instances in which patients cannot receive CT contrast, because it offers no other major advantages over CT and is a more expensive imaging modality [57].…”

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confidence: 99%

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The Pathogenesis, Diagnosis, and Management of Pancreatic Cancer

Malhotra¹,

Ahn²,

Bloomston

2015

J Gastrointest Dig Syst

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Pancreatic cancer is an aggressive and devastating disease accounting for 44,000 new cases per year in US. It is characterized by invasiveness, rapid progression and profound resistance to treatment. The majority of cases are diagnosed above age 65 with about 60% of cases at an advanced stage and 5 year survival less than 10%. Advances in molecular biology have greatly improved our understanding of pathogenesis of pancreatic cancer. Many patients have mutations of K-ras oncogene and various tumor suppressor genes are also investigated. Radical surgery remains the only curative treatment option for pancreatic cancer in early stages. For locally advanced, unresectable and metastatic disease, treatment is palliative, in form of adjuvant or neoadjuvant chemotherapy with or without radiotherapy. Gemcitabine based combinations have essentially failed to provide a substantial prolongation of survival and constitute treatment option only in patients with a good performance status. This article provides an overview of epidemiology; risks factors, molecular genetics, biomarkers, diagnostic modality and evidence based therapeutic options for resectable and palliative options for unresectable disease. Keywords: Pancreatic cancer; Diagnosis EpidemiologyPancreatic cancer is one of the most lethal human cancers and is the fourth leading cause of cancer-related deaths in the United States [1,2]. It is estimated that 38,460 of 45,220 people diagnosed with pancreatic cancer in the United States in 2013 will die of their disease, representing approximately 6% of total U.S. cancer deaths [1]. Typically a cancer of the elderly, only 13% of cases occur in patients younger than 55 years, whereas 69% of cases occur in those older than 65. There is a slight predilection for men over women in most countries. Furthermore the incidence of pancreatic cancer in the United States increased from 1999 to 2008, possibly because of the increasing prevalence of obesity and other unknown factors [1,[3][4][5]. Mortality rates have remained largely unchanged [6].The etiology of pancreatic cancer remains unclear, thus making specific risk factors allusive. Still, accepted associated risk factors include smoking, family history of chronic pancreatitis, advancing age, male gender, diabetes mellitus, obesity, non-O blood group, occupational exposures (to chlorinated hydrocarbon solvents and nickel), African American ethnic origin, a high-fat diet, diets high in meat and low in vegetables and folate, and possibly Helicobacter pylori infection and periodontal disease [7]. Findings of preliminary studies suggest that metformin could protect against development of pancreatic cancer [8,9]. A retrospective analysis of 302 patients with pancreatic cancer and diabetes found that metformin use was associated with increased survival at 2 years (30.1% vs. 15.4%; P=0.004) and increased overall survival (OS) (15.2 months vs. 11.1; P=0.009). The OS difference was significant only in patients without distant metastases and remained significant when insulin user...

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