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Cigarette smoking and pancreatitis have been associated with pancreatic adenocarcinoma in recent studies. K-ras mutations and c-erb B-2 protein appear to be important in the development of the malignant phenotype. Diagnosis by CT scan remains the most commonly used modality, although endoscopic ultrasound, positron emission tomography, and laparoscopy are important in the staging of pancreatic cancer. The Whipple resection is the gold standard of surgical treatment, whereas radical resections do not appear to increase the likelihood of cure. Neoadjuvant therapy protocols continue to be developed in an attempt to increase survival rates.