Epidemiologic studies have provided strong evidence linking chronic pancreatitis with pancreatic carcinoma. For patients with alcoholic and idiopathic chronic pancreatitis, the standardized incidence rate was 16.5; for those with tropical pancreatitis it was 100. The molecular events leading to the development of this cancer continue to be the subject of intense research, with mutations of the K-rasoncogene playing a major role. Although early diagnosis of pancreatic cancer continues to be elusive, better tools for the differential diagnosis of pancreatic and biliary strictures are becoming available. Surgery continues to offer the only possibility of cure; however, most patients still have local recurrence after resection. More aggressive treatment protocols combining preoperative chemoradiation and intraoperative radiation with surgery are being used.
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