Pancreatic cancer


Authors: T. Hucl
Authors‘ workplace: Klinika hepatogastroenterologie IKEM, Praha
Published in: Gastroent Hepatol 2012; 66(5): 350-356
Category: Gastrointestinal Oncology: Review Article

Overview

Pancreatic cancer is a disease showing increasing frequency and a devastating prognosis. Despite advances in knowledge of its biology and treatment, less than 5% of patients survive for more than 5 years. This illness is most frequently sporadic, without a known, dominant cause. The main risk factors for its development include smoking, obesity with an excessive consumption of fats, advanced age, male gender, ethnic origin, chronic pancreatitis or diabetes mellitus. Less frequently, carcinoma of the pancreas has a hereditary cause, be it as part of certain genetic syndromes or without any previously known specific genetic predisposition. Similarly to other epithelial tumours, carcinoma of the pancreas develops through gradual progression from non-invasive precursors, some of which can be identified using imaging methods. The histological progress of these precursors follows genetic progression, which forms the substance of the pathogenesis of the illness. DNA damage, or other, ­non-genetic, changes, leads to the alteration of cellular signalling pathways resulting in changes in the biological behaviour of the cells and initiation, progression and metastasizing of the disease. The main causes of the unfavourable prognosis are the early generalisation of the disease and its resistance to chemotherapy and radiotherapy. Patients with localised disease of the disease are indicated for surgical intervention followed by adjuvant chemotherapy. Locally advanced or generalised tumours are suitable for palliative chemotherapy or chemoradiotherapy. Neoadjuvant therapy is now gaining status within the therapeutic algorithm. A closer understanding of the molecular mechanisms of pathogenesis and the possibility of their influencing through targeted anti-tumour treatment, however, represent the greatest potential for the treatment of carcinoma of the pancreas.

Key words:
pancreatic neoplasms – ethiology – signalling pathway – therapy

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
20. 9. 2012

Accepted:
4. 10. 2012


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Paediatric gastroenterology Gastroenterology and hepatology Surgery

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