If the patient responds to treatment with chemotherapy, the surgical intervention is decided by the medical oncologist and surgeon depending on the R score. For example, in patient number 05, the score went down from 6 to 4, which shows the patient responded well to chemotherapeutic intervention. Therefore, in this case, the clinicians decided not to move forward with surgical intervention. The same rules were applied to all the cases. Pancreatic ductal adenocarcinoma (PDAC) accounts for over 85% of pancreatic malignancies and is a leading cause of cancer death with a 5-year survival rate of <5% (Siegel et al., 2016). Most cases of PDAC develop from precursor pancreatic intraepithelial neoplasia lesions that progressively acquire genetic alterations to develop into overt cancer.
A minority of these tumors can also develop from cystic neoplasms, including intraductal papillary mucinous neoplasms (Scarpa et al., 2018). Pancreatic Spain phone number list cancer generally presents with non-specific symptoms that can be difficult to distinguish from other diseases. Clinical features that are commonly reported at the time of diagnosis include abnormal liver enzymes (50%), abdominal pain (40–60%), new-onset diabetes (13–20%), dyspepsia (20%), nausea or vomiting (16%), and weight loss (10%; Schmidt-Hansen et al., 2016). This non-specific presentation and difficulty accessing the pancreas are challenges to the early detection of pancreatic cancer.
Imaging techniques such as CT, ultrasonography, and MRI are important for diagnosis and preoperative assessment (Hookman and Barkin, 2009; De La Cruz et al., 2014). Stents are commonly used to maintain the patency of ducts and restore flow through vessels (Serruys et al., 2006). A during imaging and make it more difficult to accurately delineate tumor margins. For example, post-treatment imaging for one patient seen in this study (patient 17, Figure 5) showed increased tumor perfusion, but tumor volume could not be measured due to stent interference.