The Genetic Basis of Sporadic Pancreatic Cancer

Adenocarcinomas of the pancreatic gland are the fifth leading cause of cancer death in the USA and western Europe with a 5-year survival rate of less than 5% and a median survival of less than 6 months [76]. They bear histological resemblance to the pancreatic ducts and are referred to as pancreatic ductal adenocarcinoma [5,34,53]. Due to the late occurrence of symptoms and the high metastatic potential, pancreatic adenocarcinomas have a dismal prognosis. Since the pancreaticoduodenectomy, a surgical resection that includes the pancreatic head, the duodenum, common bile duct and the gallbladder was introduced in 1912 by Kausch, surgery still remains the primary curative treatment. However, the 5-year survival for patients undergoing resection, is only about 20% [76] and about 80% of all cancers are unresectable at the time of diagnosis [2]. In order to improve the clinical management of cancer patients, it is mandatory to understand the genetic basis of pancreatic cancers. This review describes the histological progression of pancreatic adenocarcinomas and summarizes the underlying chromosomal and genetic alterations.