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)
