Key Points
➤ Pancreatic ductal adenocarcinoma is a disease associated with poor
prognosis, and its impact on cancer-related mortality in the United States
and worldwide is increasing.
➤ Pancreatic adenocarcinoma is a systemic disease from the outset, with
early micrometastatic spread.
➤ This disease is an unfortunate exception to the general trend of
improvement in cancer-related mortality. Indeed, one estimate suggests
that pancreatic cancer will become the second leading cause of cancer-
related death in the United States within the next decade.
➤ There were an estimated 49,000 new diagnoses and 41,000 deaths
from pancreatic cancer in the United States in 2015, and there were an
estimated 338,000 deaths worldwide in 2012.
➤ The 5-year overall survival (OS) rate remains <6%, with a median survival
time of 3–6 months for metastatic disease.
• Approximately 20% of patients present with potentially curable pancreatic cancers—
resectable or borderline resectable tumors for which surgical resection is an appropriate
consideration.
• However, even after multimodality therapy that includes surgical resection,
5 year OS rates remain at 2%.
