Pancreatic cancer

Last updated: November 7, 2023

Summarytoggle arrow icon

Pancreatic cancer is the fourth leading cause of cancer deaths in the US and typically affects older individuals in the sixth to eighth decades of life. Underlying risk factors include smoking, obesity, heavy alcohol consumption, and chronic pancreatitis. Pancreatic carcinomas are mostly ductal adenocarcinomas and frequently located in the pancreatic head. The disease is commonly diagnosed at an advanced stage because of the late onset of clinical features (e.g., epigastric pain, painless jaundice, and weight loss). In many cases, the tumor has already spread to other organs (mainly the liver) when it is diagnosed. Treatment is often palliative as surgical resection is only possible in approx. 20% of cases. The most commonly used surgical technique is the pancreaticoduodenectomy (Whipple procedure). Five-year survival rates range from 3–40% depending on the extent, spread, and resectability of the tumor. Occasionally, small, potentially resectable pancreatic lesions can be discovered on imaging. These can represent benign, precancerous, or malignant lesions. Management varies by lesion type, e.g., pancreatic cystic lesions, pancreatic neuroendocrine tumors. Screening is not routinely performed but is recommended for select high-risk individuals.

Epidemiologytoggle arrow icon

  • Age of onset: : 60–80 years [1][2]
  • Incidence
    • ∼ 3% of all new cancers in the US
    • In 2020, 57,600 individuals in the US will be newly diagnosed with pancreatic cancer ( > )
  • Mortality: accounts for ∼ 8% of all cancer deaths in the US
  • High-risk groups [3][4]
    • African Americans
    • Individuals of Jewish ancestry

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Exogenous risk factors [5][6][7]

Endogenous risk factors [5][8]

Clinical featurestoggle arrow icon

In most cases, there are no early symptoms suggestive of pancreatic cancer. [9]

Constitutional symptoms

  • Poor appetite
  • Weight loss
  • Weakness

Gastrointestinal symptoms


A thrombosis of unknown origin may be caused by an undiagnosed malignancy (especially pancreatic cancer, but also pulmonary, and prostatic carcinoma, the "3P's").

The symptoms of pancreatic cancer may be similar to those of chronic pancreatitis. Differential diagnosis is difficult since carcinoma may be accompanied by pancreatitis.

Diagnosticstoggle arrow icon

Approach [10][11][12][13]

In the majority of instances, pancreatic cancer is diagnosed in symptomatic patients once it has already spread regionally or distally and is no longer resectable. If identified at an early stage (e.g., as an incidentaloma), lesions may be resectable. Initial testing is guided by clinical presentation. Consider screening for high-risk asymptomatic individuals (see “Prevention”). [14]

Pancreatic incidentalomas should be investigated early and evaluated for curative resection.

Initial diagnostic imaging [12][16][17]

Used to identify potentially malignant lesions and evaluate for resectability

Routine laboratory studies [11][16][19]

Findings are variable and nonspecific but may show abnormalities caused by pancreatic cancer or related complications.

Diagnostic confirmation [12][16][20][21][22]

A negative biopsy does not rule out pancreatic cancer in patients with highly concerning imaging findings; consider repeat preoperative or intraoperative sampling in such cases.

Adjunctive investigations

  • MRCP
    • Typically used to rule out choledocholithiasis and assess if biliary decompression is indicated
    • Can be used adjunctively to evaluate local tumor extension [22][23]
  • ERCP: usually used when biliary decompression is indicated
  • Tumor markers: not recommended for diagnosis or screening ; [10][16][18]
    • CA 19-9
      • Prognostic marker [16]
      • Marker of cancer progression and response to therapy
    • CEA (less specific): may be used as an adjunct to CA 19-9 as a diagnostic and prognostic marker [24]

Imaging for preoperative staging [12][13]

Required to assess the extent of the tumor, the involvement of local key vascular structures, and to identify metastatic disease

  • Intraabdominal and pelvic staging: CT abdomen and pelvis (with IV and PO contrast, including pancreas-specific triphasic protocol) or MRI (including MRCP)
  • Thoracic staging: CXR or CT chest [12][25][26]

Stagestoggle arrow icon

Once the diagnosis is confirmed, pancreatic cancer should be staged to determine management. The American Joint Committee for Cancer (AJCC) TNM classification is currently the standard staging system used in clinical practice.

Pancreatic cancer staging system [27][28]
TNM classification
T1 Maximum tumor diameter ≤ 2 cm
T2 Maximum tumor diameter > 2 cm and ≤ 4 cm
T3 Maximum tumor diameter > 4 cm
T4 Tumor involves the celiac axis, common hepatic artery, and/or superior mesenteric artery
N0 No regional lymph node involvement
N1 Involvement of 1–3 regional lymph nodes
N2 Involvement of ≥ 4 regional lymph nodes
M0 No distant metastases
M1 Distant metastases
Staging groups
Stage IA T1, N0, M0
Stage IB T2, N0, M0
Stage IIA T3, N0, M0
Stage IIB Up to T3, N1, M0
Stage III Up to T3, N2, M0 or T4, any N, M0
Stage IV Any T, any N, M1

Pathologytoggle arrow icon

Location [29]

Cell origin

The majority of pancreatic malignancies are located in the head of the pancreas and originate from epithelial cells within the tubules.

Differential diagnosestoggle arrow icon

See “Subtypes and variants” for details on pancreatic cystic lesions and pancreatic neuroendocrine tumors.

The differential diagnoses listed here are not exhaustive.

Treatmenttoggle arrow icon

General principles [12][34][35]

Most patients are not candidates for surgery and require nonoperative management because they have inoperable tumors (∼ 80%), distant metastases, or are not medically fit for a major procedure. [12]

Approach [11][12][16][34][36]

Approximately 10–20% of patients present with resectable tumors, 30–40% present with borderline resectable disease, and 50–60% present with locally advanced or metastatic disease. [16]

Treatment of pancreatic cancer by disease stage
Treatment intent Resectability status [11][12][37] AJCC stage Typical treatment approach
Potentially curative Resectable disease
  • Stage I or II
Borderline resectable disease
  • Stage II or III
Usually palliative Locally advanced unresectable disease
  • Stage III
Palliative Metastatic disease
  • Stage IV
  • Combination chemotherapy; regimens vary depending on the patient's general condition and the presence of actionable genomic alterations.

The only potentially curative treatment for pancreatic cancer is surgical resection, usually in combination with other treatments. Neither chemotherapy nor radiation therapy can be curative without surgery.

Potentially curable disease [12]

Curative treatment is primarily surgical and may involve neoadjuvant and/or adjuvant therapy.


  • Primary surgical resection: recommended in patients with nonmetastatic disease who meet certain criteria.
  • Neoadjuvant therapy prior to resection: for patients with features suggestive of metastatic disease and/or less favorable performance status

Surgical resection [16][38][39]

See also “Pancreatic surgery.”

Chemotherapy and radiotherapy for potentially curable disease [12][40][41]

  • Neoadjuvant therapy: to improve resectability
    • Indication: considered in patients with a high likelihood of metastatic disease or margin-positive resection [12]
    • Regimen: usually FOLFIRINOX or gemcitabine-based regimens, though no clear consensus exits [40]
  • Adjuvant therapy: to increase long-term survival
    • Indication: all patients following surgical resection who did not receive preoperative treatment
    • Regimen: up to 6 months of chemotherapy (e.g., mFOLFIRINOX) with or without chemoradiation

Following preoperative therapy, patients require full restaging to assess for resectability. [12]

Locally advanced and metastatic disease

Treatment intent is usually palliative. Patients with locally advanced disease may be able to undergo curative surgery if preoperative treatment leads to improved resectability; however, this is rare. [42]

Supportive care [12][16][34]

For general guidance on supportive care for cancer and/or treatment-related complications, see “Principles of cancer care” and “Overview of palliative medicine.”

Pain management [12][34][35]

Severe pain is common in the course of tumor progression. See “Treatment of pain” and “Pain management in palliative care” for additional guidance.

  • Pharmacotherapy
  • Radiotherapy: Consider for patients with symptomatic metastases, especially to the brain and bones (rare).
  • Advanced interventions: Consider for patients with refractory abdominal pain. [43]

Cancer anorexia-cachexia syndrome [12][34][42]

Monitoring and follow-up [44]

Data to guide monitoring for recurrence and follow-up recommendations after curative treatment for pancreatic cancer is limited. The following recommendations are based on expert opinion and consistent with the 2016 American Society of Clinical Oncology (ASCO) guidelines. [12]

  • Follow-up frequency: every 3–6 months for 2 years, then every 6–12 months
  • Follow-up evaluation

Complicationstoggle arrow icon


Lymphogenic and hematogenous metastases are often already present at the time of diagnosis.

Management of GI complications [34][45][46]

Thromboembolic disease

Patients with pancreatic cancer are at a very high risk of VTE.


We list the most important complications. The selection is not exhaustive.

Prognosistoggle arrow icon

  • Very aggressive course [1]
  • Median survival for patients who undergo successful resection: ∼ 18 months (5-year survival rate: ∼ 20%) [47]

Subtypes and variantstoggle arrow icon

Pancreatic cystic lesions [48][49][50][51][52]

  • Description
    • Epithelium-lined cyst, filled with serous or mucous liquid
    • Can be benign, precancerous, or cancerous
  • Clinical features: usually asymptomatic
  • Diagnosis: most often found incidentally; on CT or MRI abdomen; can be followed by endoscopic investigations (e.g., EUS, ERCP) and tissue sampling (e.g., FNA)
  • Management: varies depending on radiological and pathological features (e.g., size, location, degree of cell dysplasia) and patient characteristics (e.g., symptoms, preoperative risk assessment) [52]
    • Offer surgical resection to patients with:
    • Consider conservative management for asymptomatic individuals with low-risk lesions, e.g.:
      • Serial MRI (e.g., annually)
      • Tissue sampling (e.g., EUS with FNA) of lesions that develop suspicious radiological features
      • Referral for surgical resection in patients with worrisome pathology

Pancreatic cysts are common in patients with von Hippel-Lindau syndrome. [53]

Benign lesions [54]

Benign lesions have low malignancy potential and are typically managed conservatively.

  • Serous cystadenomas: typically appears as a honeycomb-like cluster of cystic lesions [50]
  • Simple cysts (retention cysts): typically appear as a single well-defined, nonenhancing, unilocular cyst without mural nodularity or calcification [51]

Precancerous lesions [52][54][55][56]

Surgical resection is usually offered to good surgical candidates; conservative management can be considered in select cases.

  • Intraductal papillary mucinous neoplasms (IPMNs): most common pancreatic cystic neoplasm; malignancy potential 20–80% [54][57]
  • Mucinous cyst neoplasm: most commonly affects women; malignancy potential up to 25% [50]
  • Solid pseudopapillary neoplasms: most commonly affects young women; malignancy potential 10–15% [58]

Main-duct IPMNs have the highest malignancy potential (up to 80%) and should be evaluated early for surgical resection (e.g., pancreaticoduodenectomy). [54]

Pancreatic neuroendocrine tumors (PNETs) [59][60]

See also “Pancreatic neuroendocrine tumors” and dedicated articles on “Insulinoma” and “Gastrinoma.”

Screeningtoggle arrow icon

There are no specific biomarkers for pancreatic cancer screening. [14]

Referencestoggle arrow icon

  1. Owens DK, Davidson KW, et al. Screening for Pancreatic Cancer: US Preventive Services Task Force Reaffirmation Recommendation Statement.. JAMA. 2019; 322 (5): p.438-444.doi: 10.1001/jama.2019.10232 . | Open in Read by QxMD
  2. Aslanian HR, Lee JH, Canto MI. AGA Clinical Practice Update on Pancreas Cancer Screening in High-Risk Individuals: Expert Review. Gastroenterology. 2020; 159 (1): p.358-362.doi: 10.1053/j.gastro.2020.03.088 . | Open in Read by QxMD
  3. Cancer Stat Facts: Pancreas Cancer. Updated: January 11, 2017. Accessed: January 11, 2017.
  4. Pancreatic cancer risk factors. Updated: April 5, 2016. Accessed: January 11, 2017.
  5. Hamada T, Yuan C, Yurgelun MB, et al. Family history of cancer, Ashkenazi Jewish ancestry, and pancreatic cancer risk. Br J Cancer. 2019; 120 (8): p.848-854.doi: 10.1038/s41416-019-0426-5 . | Open in Read by QxMD
  6. Eldridge RC et al.. Jewish Ethnicity and Pancreatic Cancer Mortality in a Large U.S. Cohort. Cancer Epidemiol Biomarkers Prev. 2011; 20 (4): p.691-698.doi: 10.1158/1055-9965.epi-10-1196 . | Open in Read by QxMD
  7. Pancreatic Cancer Risk Factors. Updated: May 31, 2016. Accessed: September 3, 2017.
  8. Edderkaoui M, Thrower E. Smoking and pancreatic disease. J Cancer Ther. 2013; 4 (10A): p.34-40.doi: 10.4236/jct.2013.410A005 . | Open in Read by QxMD
  9. Alcohol Use and Cancer. Updated: April 5, 2017. Accessed: September 3, 2017.
  10. Pancreatic Cancer Risk Factors. . Accessed: September 3, 2017.
  11. Signs and Symptoms of Pancreatic Cancer. Updated: February 11, 2019. Accessed: November 10, 2020.
  12. McGuigan A, Kelly P, Turkington RC, et al. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018; 24 (43): p.4846-4861.doi: 10.3748/wjg.v24.i43.4846 . | Open in Read by QxMD
  13. The European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018; 67 (5): p.789-804.doi: 10.1136/gutjnl-2018-316027 . | Open in Read by QxMD
  14. Karoumpalis I. Cystic lesions of the pancreas. Ann Gastroenterol. 2016; 29 (2).doi: 10.20524/aog.2016.0007 . | Open in Read by QxMD
  15. Bergin D, Ho LM, Jowell PS, et al. Simple pancreatic cysts: CT and endosonographic appearances.. AJR Am J Roentgenol. 2002; 178 (4): p.837-40.doi: 10.2214/ajr.178.4.1780837 . | Open in Read by QxMD
  16. Vege SS, Ziring B, Jain R, et al. American Gastroenterological Association Institute Guideline on the Diagnosis and Management of Asymptomatic Neoplastic Pancreatic Cysts. Gastroenterology. 2015; 148 (4): p.819-822.doi: 10.1053/j.gastro.2015.01.015 . | Open in Read by QxMD
  17. van Asselt SJ, de Vries EG, van Dullemen HM, et al. Pancreatic cyst development: insights from von Hippel-Lindau disease. Cilia. 2013; 2 (1).doi: 10.1186/2046-2530-2-3 . | Open in Read by QxMD
  18. Weissman S, Thaker RK, Zeffren N, et al. Intraductal Papillary Mucinous Neoplasm of the Pancreas: Understanding the Basics and Beyond. Cureus. 2019.doi: 10.7759/cureus.3867 . | Open in Read by QxMD
  19. Distler M, Aust D, Weitz J, et al. Precursor Lesions for Sporadic Pancreatic Cancer: PanIN, IPMN, and MCN. Biomed Res Int. 2014; 2014: p.1-11.doi: 10.1155/2014/474905 . | Open in Read by QxMD
  20. Basturk O, Hong SM, Wood LD, et al. A Revised Classification System and Recommendations From the Baltimore Consensus Meeting for Neoplastic Precursor Lesions in the Pancreas.. Am J Surg Pathol. 2015; 39 (12): p.1730-41.doi: 10.1097/PAS.0000000000000533 . | Open in Read by QxMD
  21. Adsay V, Mino-Kenudson M, Furukawa T, et al. Pathologic Evaluation and Reporting of Intraductal Papillary Mucinous Neoplasms of the Pancreas and Other Tumoral Intraepithelial Neoplasms of Pancreatobiliary Tract. Ann Surg. 2016; 263 (1): p.162-177.doi: 10.1097/sla.0000000000001173 . | Open in Read by QxMD
  22. Vassos N, Agaimy A, Klein P, Hohenberger W, Croner RS. Solid-pseudopapillary neoplasm (SPN) of the pancreas: case series and literature review on an enigmatic entity.. International journal of clinical and experimental pathology. 2013; 6 (6): p.1051-9.
  23. Perri G, Prakash LR, Katz MHG. Pancreatic neuroendocrine tumors. Curr Opin Gastroenterol. 2019; 35 (5): p.468-477.doi: 10.1097/mog.0000000000000571 . | Open in Read by QxMD
  24. Low G, Panu A, Millo N, Leen E. Multimodality imaging of neoplastic and nonneoplastic solid lesions of the pancreas.. Radiographics. 2011; 31 (4): p.993-1015.doi: 10.1148/rg.314105731 . | Open in Read by QxMD
  25. Van Roessel S, Kasumova GG, Verheij J, et al. International Validation of the Eighth Edition of the American Joint Committee on Cancer (AJCC) TNM Staging System in Patients With Resected Pancreatic Cancer. JAMA Surgery. 2018; 153 (12): p.e183617.doi: 10.1001/jamasurg.2018.3617 . | Open in Read by QxMD
  26. Cong L, Liu Q, Zhang R, et al. Tumor size classification of the 8th edition of TNM staging system is superior to that of the 7th edition in predicting the survival outcome of pancreatic cancer patients after radical resection and adjuvant chemotherapy. Scientific Reports. 2018; 8 (1).doi: 10.1038/s41598-018-28193-4 . | Open in Read by QxMD
  27. Ducreux M, Cuhna AS, Caramella C, et al. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015; 26 (Suppl 5): p.v56-68.doi: 10.1093/annonc/mdv295 . | Open in Read by QxMD
  28. Yabar CS, Winter JM. Pancreatic Cancer. Gastroenterol Clin North Am. 2016; 45 (3): p.429-445.doi: 10.1016/j.gtc.2016.04.003 . | Open in Read by QxMD
  29. Khorana AA, Mangu PB, Berlin J, et al. Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. Journal of Clinical Oncology. 2016; 34 (21): p.2541-2556.doi: 10.1200/jco.2016.67.5553 . | Open in Read by QxMD
  30. Qayyum A, Tamm EP, Kamel IR, et al. ACR Appropriateness Criteria® Staging of Pancreatic Ductal Adenocarcinoma. J Am Coll Radiol. 2017; 14 (11): p.S560-S569.doi: 10.1016/j.jacr.2017.08.050 . | Open in Read by QxMD
  31. Santo E, Bar-Yishay I. Pancreatic solid incidentalomas. Endosc Ultrasound. 2017; 6 (Suppl 3): p.S99-S103.doi: 10.4103/eus.eus_72_17 . | Open in Read by QxMD
  32. Kleeff J, Korc M, Apte M, et al. Pancreatic cancer. Nat Rev Dis Primers. 2016; 2 (1).doi: 10.1038/nrdp.2016.22 . | Open in Read by QxMD
  33. Almeida RR, Lo GC, Patino M, et al.. Advances in Pancreatic CT Imaging.. AJR Am J Roentgenol. 2018; 211 (1): p.52-66.doi: 10.2214/AJR.17.18665 . | Open in Read by QxMD
  34. De La Cruz MS, Young AP, Ruffin MT. Diagnosis and management of pancreatic cancer.. Am Fam Physician. 2014; 89 (8): p.626-32.
  35. Ludwig H, Muldur E, Endler G, et al.. Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia. Ann Oncol. 2013; 24 (7): p.1886-1892.doi: 10.1093/annonc/mdt118 . | Open in Read by QxMD
  36. Yousaf MN, Chaudhary FS, Ehsan A, et al. Endoscopic ultrasound (EUS) and the management of pancreatic cancer. BMJ Open Gastro. 2020; 7 (1): p.e000408.doi: 10.1136/bmjgast-2020-000408 . | Open in Read by QxMD
  37. Rustgi SD, Amin S, Yang A, et al. Preoperative Endoscopic Retrograde Cholangiopancreatography Is Not Associated With Increased Pancreatic Cancer Mortality.. Clin Gastroenterol Hepatol. 2019; 17 (8): p.1580-1586.e4.doi: 10.1016/j.cgh.2018.11.056 . | Open in Read by QxMD
  38. Vasen HF, Wasser M, van Mil A, et al. Magnetic resonance imaging surveillance detects early-stage pancreatic cancer in carriers of a p16-Leiden mutation.. Gastroenterology. 2011; 140 (3): p.850-6.doi: 10.1053/j.gastro.2010.11.048 . | Open in Read by QxMD
  39. ACR Appropriateness Criteria: Acute Pancreatitis. Updated: November 1, 2019. Accessed: January 30, 2020.
  40. Meng Q, Shi S, Liang C, et al. Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis. Onco Targets Ther. 2017; Volume 10: p.4591-4598.doi: 10.2147/ott.s145708 . | Open in Read by QxMD
  41. Mehtsun WT, Chipidza FE, Fernández-del Castillo C, et al. Are Staging Computed Tomography (CT) Scans of the Chest Necessary in Pancreatic Adenocarcinoma?. Ann Surg Oncol. 2018; 25 (13): p.3936-3942.doi: 10.1245/s10434-018-6764-3 . | Open in Read by QxMD
  42. Pappas SG, Christians KK, Tolat PP, et al. Staging chest computed tomography and positron emission tomography in patients with pancreatic adenocarcinoma: utility or futility?. HPB. 2014; 16 (1): p.70-74.doi: 10.1111/hpb.12074 . | Open in Read by QxMD
  43. Artinyan A, Soriano PA, Prendergast C, Low T, Ellenhorn JDI, Kim J. The anatomic location of pancreatic cancer is a prognostic factor for survival. HPB. 2008; 10 (5): p.371-376.doi: 10.1080/13651820802291233 . | Open in Read by QxMD
  44. What is pancreatic cancer?. Updated: April 5, 2016. Accessed: January 11, 2017.
  45. Elbanna KY, Jang HJ, Kim TK. Imaging diagnosis and staging of pancreatic ductal adenocarcinoma: a comprehensive review. Insights Imaging. 2020; 11 (1).doi: 10.1186/s13244-020-00861-y . | Open in Read by QxMD
  46. Kim SS, Choi GC, Jou SS. Pancreas Ductal Adenocarcinoma and its Mimics: Review of Cross-sectional Imaging Findings for Differential Diagnosis.. J Belg Soc Radiol. 2018; 102 (1): p.71.doi: 10.5334/jbsr.1644 . | Open in Read by QxMD
  47. Aithal Sitharama S, Bashini M, Gunasekaran K, et al. Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging.. BJR case rep. 2016; 2 (4): p.20150507.doi: 10.1259/bjrcr.20150507 . | Open in Read by QxMD
  48. Sohal DPS, Mangu PB, Khorana AA, et al. Metastatic Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2016; 34 (23): p.2784-2796.doi: 10.1200/jco.2016.67.1412 . | Open in Read by QxMD
  49. Habermehl D, Brecht IC, Debus J, Combs SE. Palliative radiation therapy in patients with metastasized pancreatic cancer - description of a rare patient group.. Eur J Med Res. 2014; 19: p.24.doi: 10.1186/2047-783X-19-24 . | Open in Read by QxMD
  50. Sohal DPS, Kennedy EB, Cinar P, et al. Metastatic Pancreatic Cancer: ASCO Guideline Update.. J Clin Oncol. 2020: p.JCO2001364.doi: 10.1200/JCO.20.01364 . | Open in Read by QxMD
  51. Al-Hawary MM, Francis IR, Chari ST, et al. Pancreatic Ductal Adenocarcinoma Radiology Reporting Template: Consensus Statement of the Society of Abdominal Radiology and the American Pancreatic Association. Radiology. 2014; 270 (1): p.248-260.doi: 10.1148/radiol.13131184 . | Open in Read by QxMD
  52. Hüttner FJ, Fitzmaurice C, Schwarzer G, et al. Pylorus-preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment of periampullary and pancreatic carcinoma. Cochrane Database Syst Rev. 2016; 2016 (2).doi: 10.1002/14651858.cd006053.pub6 . | Open in Read by QxMD
  53. Warshaw AL, Thayer SP. Pancreaticoduodenectomy.. J Gastrointest Surg. 2004; 8 (6): p.733-41.doi: 10.1016/j.gassur.2004.03.005 . | Open in Read by QxMD
  54. Oba A, Ho F, Bao QR, et al.. Neoadjuvant Treatment in Pancreatic Cancer.. Front Oncol. 2020; 10: p.245.doi: 10.3389/fonc.2020.00245 . | Open in Read by QxMD
  55. Khorana AA, McKernin SE, Berlin J, et al. Potentially Curable Pancreatic Adenocarcinoma: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2019; 37 (23): p.2082-2088.doi: 10.1200/jco.19.00946 . | Open in Read by QxMD
  56. Balaban EP, Mangu PB, Khorana AA, et al. Locally Advanced, Unresectable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline.. J Clin Oncol. 2016; 34 (22): p.2654-68.doi: 10.1200/JCO.2016.67.5561 . | Open in Read by QxMD
  57. Jones WB, Jordan P, Pudi M. Pain management of pancreatic head adenocarcinomas that are unresectable: celiac plexus neurolysis and splanchnicectomy.. J Gastrointest Oncol. 2015; 6 (4): p.445-51.doi: 10.3978/j.issn.2078-6891.2015.052 . | Open in Read by QxMD
  58. Wong SK, Gondara L, Renouf DJ, et al. Impact of surveillance among patients with resected pancreatic cancer following adjuvant chemotherapy. J Gastrointest Oncol. 2021; 12 (2): p.446-454.doi: 10.21037/jgo-20-422 . | Open in Read by QxMD
  59. Moole H, Dharmapuri S, Duvvuri A, et al. Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review.. Can J Gastroenterol Hepatol. 2016; 2016: p.4726078.doi: 10.1155/2016/4726078 . | Open in Read by QxMD
  60. Koop AH, Palmer WC, Stancampiano FF. Gastric outlet obstruction: A red flag, potentially manageable. Cleve Clin J Med. 2019; 86 (5): p.345-353.doi: 10.3949/ccjm.86a.18035 . | Open in Read by QxMD
  61. Chakraborty S, Singh S. Surgical resection improves survival in pancreatic cancer patients without vascular invasion- a population based study.. Annals of gastroenterology. 2013; 26 (4): p.346-352.

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