**Molecular Mechanisms**

**Chapter 1**

**The Molecular Frame of Pancreatic Carcinogenesis**

Annually, approximately 43,140 people are diagnosed (incidence 10-12/100000) with pancre‐ atic ductal adenocarcinoma (PDAC) in the United States and the mortality rate of 36800 almost equals this number [1]. PDAC ranks fourth on the list of cancer-related causes of death and despite extensive scientific and clinical effort, the prognosis of this exceptionally lethal disease has not improved significantly over the past decades [2]. Surgical resection, for which only a minority (less than 20%) of the patients qualify due to late diagnosis in advanced stages, is currently the only chance of cure, improving 5-year survival rates from <4% if left untreated to 20-30% after resection [3]. Unresectable tumors are characterized by early invasion and metastases as well as by an extreme chemoresistance. Despite subtle progress over the years in terms of therapeutic strategies in many malignancies, no major conventional treatment

Considering its bad prognosis much effort was put into revealing the hidden secrets of pancreatic cancer that explain the severity of this disease. Among the different fields of tumor biology in pancreatic cancer research, this chapter will focus on the morphological and

Although there was little improvement in pancreatic cancer treatment during the past decades, much effort has been made in understanding the pathogenesis of pancreatic cancer. In contrast to its rapid progress after diagnosis, recent published data clearly show that the clonal

> © 2014 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

options have come forward from numerous clinical trials in pancreatic cancer.

molecular features that cause and accompany pancreatic carcinogenesis.

**2. Morphological features of pancreatic carcinogenesis**

Elisabeth Heßmann, Sandra Baumgart, Nai ming Chen, Shiv Singh, Garima Singh,

http://dx.doi.org/10.5772/57422

**1. Introduction**

Alex König, Albrecht Neeße and Volker Ellenrieder

Additional information is available at the end of the chapter
