ASCO GUIDELINES Bundle

Potentially Curable Pancreatic Adenocarcinoma

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Introduction ➤ The purpose of this guideline update is to incorporate practice- changing evidence into the American Society of Clinical Oncology's recommendations on potentially curable pancreatic adenocarcinoma. Treatment Recommendation 1.1 ➤ A multiphase computed tomography (CT) scan of the abdomen and pelvis using a pancreatic protocol or magnetic resonance imaging (MRI) should be performed for all patients with pancreatic cancer to assess the anatomic relationships of the primary tumor and to assess for the presence of intra-abdominal metastases. Endoscopic ultrasonography and/or diagnostic laparoscopy may be used as supplemental studies, and to facilitate acquisition of a biopsy specimen. A chest X-ray may be performed to stage the thorax. Other staging studies should be performed only as dictated by symptom burden. A serum level of CA 19-9 and baseline standard laboratory studies should be assayed. (Strong Recommendation; EB-B-H) Recommendation 1.2 ➤ The baseline performance status, symptom burden, and comorbidity profile of a person diagnosed with potentially curable pancreatic cancer should be carefully evaluated. (Strong Recommendation; EB- B-H) Recommendation 1.3 ➤ The goals of care (including a discussion of advance directives), patient preferences, and support systems should be discussed with every person diagnosed with potentially curable pancreatic cancer and his or her caregivers. (Strong Recommendation; EB-B-I)

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