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WHO Classification of Tumours
Ductal adenocarcinoma
Pancreas


Definition

A malignant tumour derived from ductal epithelia. Microscopically, randomly arranged epithelial elements are seen. When large sheets of malignant cells are present, necrosis may be seen. With adequate tissue sampling, in situ carcinoma can be demonstrated in association with the infiltrating carcinoma.

Infiltrating duct carcinoma of the pancreas
The epidemiological study of pancreatic carcinomas is complicated by significant geographical and temporal variations in the sensitivity and specificity of clinical diagnosis and in the proportion of cases that are histologically verified. The best-known risk factor for pancreatic cancer is tobacco smoking, but nutritional and dietary factors such as obesity, low physical activity, low intake of vegetables and fruits, as well as preexisting conditions such as chronic pancreatitis, diabetes mellitus and patients with gastrectomy have been reported. Ductal adenocarcinoma is fatal in almost all cases

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Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009)
Cancer statistics, 2009.
CA Cancer J Clin 59: 225-49



. The mean survival time for untreated patients is 3–5 months, while the mean survival after surgical resection ranges from 10 to 20 months
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Conlon KC, Klimstra DS, Brennan MF (1996)
Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors.
Ann Surg 223: 273-9




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Henne-Bruns D, Vogel I, Lüttges J, Klöppel G, Kremer B (1998)
Ductal adenocarcinoma of the pancreas head: survival after regional versus extended lymphadenectomy.
Hepatogastroenterology 45: 855-66




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Isaji S, Kawarada Y, Uemoto S (2004)
Classification of pancreatic cancer: comparison of Japanese and UICC classifications.
Pancreas 28: 231-4




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Ishikawa O, Ohigashi H, Imaoka S, Furukawa H, Sasaki Y, Fujita M, Kuroda C, Iwanaga T (1992)
Preoperative indications for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein.
Ann Surg 215: 231-6




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Kuhlmann KF, de Castro SM, Wesseling JG, ten Kate FJ, Offerhaus GJ, Busch OR, van Gulik TM, Obertop H, Gouma DJ (2004)
Surgical treatment of pancreatic adenocarcinoma; actual survival and prognostic factors in 343 patients.
Eur J Cancer 40: 549-58




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Neoptolemos JP, Stocken DD, Dunn JA, Almond J, Beger HG, Pederzoli P, Bassi C, Dervenis C, Fernandez-Cruz L, Lacaine F, Buckels J, Deakin M, Adab FA, Sutton R, Imrie C, Ihse I, Tihanyi T, Olah A, Pedrazzoli S, Spooner D, Kerr DJ, Friess H, Büchler MW, (2001)
Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial.
Ann Surg 234: 758-68




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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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> Histological variants
Adenosquamous carcinoma
Colloid carcinoma (Mucinous noncystic carcinoma/adenocarcinoma)
Hepatoid adenocarcinoma
Medullary carcinoma
Signet ring cell carcinoma
Poorly differentiated carcinoma
Carcinoma with osteoclast-like giant cells