**1. Introduction**

Pancreatic cancer is one of the most lethal malignancies, ranking as the fourth leading cause of death from cancer in the United States. Despite a variety of improved diagnostic and therapeutic approaches over the past several decades the mortality rate has not significantly improved. There is wide variation in the therapeutic approach to pancreatic cancer based upon multiple factors such as the stage at presentation, patient's coexisting medical comorbidities, etc. and at times the optimal treatment strategy is still controversial.
