Pancreatic Cancer - Diagnosis and Management
 • Exocrine/ ...
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Description

Pancreatic Cancer - Diagnosis and Management

 • Exocrine/ adenoca (94%), Endocrine (6%)

 • Risk factors: Smoking, ETOH, obesity, DM, chronic pancreatitis, age, male, FH pancreatic CA, HNPCC, BRCA1/2

Staging: Staged I-IV using TNM system

Diagnostics:

 • CT C/A/P pancreas protocol, EUS, MRCP, ERCP if indicated, CA19-9

 • Determine resectability based on vascular involvement

Treatment:

 • Resectable: surgery + adjuvant chemoRT

 • Borderline resectable: neoadjuvant chemo & surgery +/- adjuvant chemoRT

 • Locally adv: chemoRT or stereotactic body radiation therapy (SBRT)

 • Metastatic (NEJM 2011;364:1817): FOLFIRIMOX or gemcitabine +/- nab-paclitaxel +/- palliative RT

 • BRCA: FOLFIRINOX or gemcitabine/cisplatin, +/- chemoRT

 • MSI-H/dMMR (NEJM 2015;372:2509): consider pembrolizumab



#Pancreatic #Cancer #Diagnosis #Management #oncology #treatment
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