Vnitr Lek 2022, 68(6):363-370 | DOI: 10.36290/vnl.2022.076

Current trends in the diagnosis of pancreatic cancer

Petr Vanek^{1, 2}, Michal Eid³, Robert Psar^{2, 4, 5}, Vincent Zoundjiekpon^{1, 2}, Ondrej Urban^{1, 2}, Lumir Kunovsky^{1, 2, 6, 7}

¹ 2nd Department of Internal Medicine - Gastroenterology and Geriatrics, University Hospital Olomouc, Olomouc, Czech Republic

² Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic

³ Department of Hematology, Oncology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic

⁴ Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic

⁵ Department of Radiology, Vitkovice Hospital, Ostrava, Czech Republic

⁶ Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic

⁷ Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute, Brno, Czech Republic

Pancreatic ductal adenocarcinoma (PDAC) is a dreaded malignancy with a dismal 5-year survival rate despite maximal efforts on optimizing treatment strategies. Currently, early detection is considered to be the most effective way to improve survival as radical resection is the only potential cure. PDAC is often divided into four categories based on the extent of disease: resectable, borderline resectable, locally advanced, and metastatic. Unfortunately, the majority of patients are diagnosed with locally advanced or metastatic disease, which renders them ineligible for curative resection. This is mainly due to the lack of or vague symptoms while the disease is still localized, although appropriate utilization and prompt availability of adequate diagnostic tools is also critical given the aggressive nature of the disease. A cost-effective biomarker with high specificity and sensitivity allowing early detection of PDAC without the need for advanced or invasive methods is still not available. This leaves the diagnosis dependent on radiodiagnostic methods or endoscopic ultrasound. Here we summarize the latest epidemiological data, risk factors, clinical manifestation, and current diagnostic trends and implications of PDAC focusing on serum biomarkers and imaging modalities. Additionally, up-to-date management and therapeutic algorithms are outlined.

Keywords: pancreas, pancreatic cancer, pancreatic ductal adenocarcinoma, pancreatic cancer diagnosis, pancreatic cancer management, pancreatic cancer therapy.

Accepted: September 23, 2022; Published: October 3, 2022  Show citation