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Metastatic Pancreatic Cancer — RACP Adult Medicine MCQ

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ModerateGastroenterologyMetastatic Pancreatic CancerRACP Adult Medicine

A 65-year-old woman presents with painless jaundice and a palpable gallbladder (Courvoisier sign). CT shows a 4 cm pancreatic head mass encasing the superior mesenteric artery with liver metastases. CA 19-9 is markedly elevated. Biopsy confirms pancreatic adenocarcinoma. ECOG PS is 1. What is the most appropriate management?

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Correct answer: B — Palliative chemotherapy alone

Metastatic pancreatic adenocarcinoma is not surgically resectable. Palliative chemotherapy (FOLFIRINOX for PS 0-1, or gemcitabine-nab-paclitaxel) improves survival. ERCP stenting for biliary obstruction may be needed for symptom relief. Palliative care should be integrated early.

Reference: AGITG – 2024 – Pancreatic Cancer Guidelines