Clinical presentation and prognosis of adenosquamous carcinoma of the pancreas

• Verfasst von: Kaiser, Jörg [VerfasserIn]
• Verfasst von: Hinz, Ulf [VerfasserIn]
• Verfasst von: Mayer, Philipp [VerfasserIn]
• Verfasst von: Hank, Thomas [VerfasserIn]
• Verfasst von: Niesen, Willem [VerfasserIn]
• Verfasst von: Hackert, Thilo [VerfasserIn]
• Verfasst von: Gaida, Matthias [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Strobel, Oliver [VerfasserIn]
• Titel: Clinical presentation and prognosis of adenosquamous carcinoma of the pancreas
• Titelzusatz: matched-pair analysis with pancreatic ductal adenocarcinoma
• Verf.angabe: Joerg Kaiser, Ulf Hinz, Philipp Mayer, Thomas Hank, Willem Niesen, Thilo Hackert, Matthias M. Gaida, Markus W. Büchler, Oliver Strobel
• E-Jahr: 2021
• Jahr: 16 February 2021
• Umfang: 8 S.
• Fussnoten: Gesehen am 14.07.2021
• Titel Quelle: Enthalten in: European journal of surgical oncology
• Ort Quelle: Burlington, Mass. : Harcourt, 1995
• Jahr Quelle: 2021
• Band/Heft Quelle: 47(2021), 7 vom: Juli, Seite 1734-1741
• ISSN Quelle: 1532-2157
• DOI: doi:10.1016/j.ejso.2021.02.011
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adenosquamous carcinoma
• Sach-SW: Outcome
• Sach-SW: Pancreas
• Sach-SW: Prognosis
• Sach-SW: Survival
• K10plus-PPN: 1762909669

Abstract

Introduction - Adenosquamous carcinoma of the pancreas (ASCP) is a rare subtype of pancreatic adenocarcinoma. The aim of this study was to investigate the characteristics and outcomes of ASCP in comparison to pancreatic ductal adenocarcinoma (PDAC). - Materials and methods - All patients with ASCP treated between December 2001 and December 2017 were identified from a prospective database. Clinicopathological and follow-up data were analyzed. A nested case-control-study with matched-pair analysis was performed to compare overall survival of ASCP and PDAC. - Results - Of 4009 patients undergoing surgery for pancreatic adenocarcinoma 91 patients had ASCP. Compared to PDAC ASCP were larger (4.0 vs. 3.2 cm; p < 0.0001), more frequently involved lymph nodes (88% vs. 78%; p = 0.0216), more frequently showed poor differentiation (G3: 79% vs. 36%; p < 0.0001) and more frequently were located in the pancreatic tail (19% vs. 10%; p = 0.0179). Overall median post-resection-survival was shorter in ASCP (10.8 vs. 20.5 months in PDAC; p = 0.0085), but 5-year survival rates were comparable (18.2% vs. 17.5%). After matching for the unevenly distributed prognostic factors survival after resection of ASCP and PDAC was comparable (p = 0.8301). Localization in the head or several parts of the pancreas, high CA 19-9 levels, and M1 disease were independent predictors of survival in patients with ASCP. - Conclusion - ASCP is more aggressive with poorer differentiation and higher rates of lymph node metastases compared to PDAC. In spite of a shorter median survival, 5-year survival rates after surgical resection of about 18% can be expected in ASCP and support resection as part of a multimodal therapy as the treatment of choice in this rare cancer.