Pancreatic cancer – the past, the present, and the future

Figures & data

Figure 1. Global incidence rates for pancreatic cancer in 2020. Source: GLOBOCAN 2020; https://gco.iarc.fr.

Figure 2. Projected incidence and mortality rates for pancreatic cancer from 2020 to 2040 in Europe. Source: GLOBOCAN 2020; https://gco.iarc.fr.

Figure 3. Development model of pancreatic ductal adenocarcinoma (PDAC). The driver genes may be altered sequentially or simultaneously via chromothripsis. PanIN, pancreatic intraepithelial neoplasia.

Figure 4. Early detection of pancreatic cancer improves survival rates.

Figure 5. The case for early detection of pancreatic cancer in high-risk groups.

Table 1. Potential advantages and disadvantages with neoadjuvant chemotherapy in resectable pancreatic cancer.

Advantages All patients receive chemotherapy Micrometastatic disease treated earlier Avoid futile surgery (progression) Rendering the patients time to improve performance Improved R0 resection and less positive lymph nodes Less POPF (postoperative pancreatic fistula; tissue fibrosis)

Disadvantages Complications related to invasive procedures (ERCP, PTC, EUS/FNA) Low rate of complete or clinically relevant pathologic or radiological response Systemic toxicity to chemotherapy Progression during neoadjuvant chemotherapy