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Pancreatic cancer in young adults: changes, challenges, and solutions

Authors Primavesi F, Stättner S, Schlick K, Kiesslich T, Mayr C, Klieser E, Urbas R, Neureiter D

Received 15 January 2019

Accepted for publication 27 February 2019

Published 6 May 2019 Volume 2019:12 Pages 3387—3400


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Arseniy Yuzhalin

Florian Primavesi,1 Stefan Stättner,1 Konstantin Schlick,2 Tobias Kiesslich,3,4 Christian Mayr,3,4 Eckhard Klieser,5,6 Romana Urbas,5,6 Daniel Neureiter5,6

1Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria; 2Department of Internal Medicine III – Division of Hematology, Medical Oncology, Hemostaseology, Rheumatology, Infectiology and Oncologic Center, Paracelsus Medical University, Salzburg, Austria; 3Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria; 4Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria; 5Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria; 6Cancer Cluster Salzburg, Salzburg, Austria

Abstract: Despite improvements in multidisciplinary treatments, survival of pancreatic cancer (PC) patients remains dismal. Studies dealing with early onset pancreatic cancer (EOPC) patients are scarce. In this review, we discuss differences between EOPC and late-onset pancreatic cancer based on findings in original papers and reviews with a focus on morphology, genetics, clinical outcomes and therapy. In conclusion, families with a positive history of PC and patients with BRCA 1 or 2 mutations should be monitored. Patients with EOPC usually present with better overall fitness compared to the average PC population, however often with even more aggressive cancer behaviour. Therefore, potent state-of-the-art multi-modal systemic therapies should be applied whenever possible. Large-scale registries and randomized clinical trials dealing with EOPC in regard to distinct biology and outcome are warranted.

Keywords: early onset pancreatic cancer, risk factors, resectability, chemotherapy, surgery

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