Pancreatic Tumors

Genetics and path (Nat Rev Dis Primers 2016;2:16022)

  • Histologic types: adenocarcinoma (~85%), acinar cell carcinoma, endocrine tumors, cystic neoplasms (<10%); rarely, mets to pancreas (eg, lung, breast, renal cell)
  • Location: ~60% in head, 15% in body, 5% in tail; in 20% diffuse infiltration of pancreas
  • Mutations in adenoca.: KRAS (>90%), p16 (80–95%), p53 (50–75%), SMAD4 (~55%)

Epidemiology and risk factors (Lancet 2016;388:73)

  • 4th leading cause of cancer death in U.S.; 80% panc adeno in ages 60–80 y; M>F (1.3:1)
  • Acquired risk factors: smoking (RR ~1.5; 25% cases), obesity, ronic pancreatitis, T2DM