Pancreatic Adenosquamous Carcinoma: Experience Within an Integrated Health Care System.

Autor: Kwak HV; Department of Surgery, University of California San Francisco - East Bay, Oakland, CA, USA., Hsu DS; Department of Surgery, University of California San Francisco - East Bay, Oakland, CA, USA., Chang A; University of California Davis, Davis, CA, USA., Kazantsev GB; Department of Surgery, Kaiser Permanente Oakland Medical Cente, Oakland, CA, USA., Peng PD; Department of Surgery, Kaiser Permanente Oakland Medical Cente, Oakland, CA, USA., Spitzer AL; Department of Surgery, Kaiser Permanente Oakland Medical Cente, Oakland, CA, USA., Chang CK; Department of Surgery, Kaiser Permanente Oakland Medical Cente, Oakland, CA, USA.
Jazyk: angličtina
Zdroj: The Permanente journal [Perm J] 2023 Jun 15; Vol. 27 (2), pp. 9-12. Date of Electronic Publication: 2022 Nov 06.
DOI: 10.7812/TPP/22.095
Abstrakt: Introduction Adenosquamous carcinoma (ASC) of the pancreas is a rare form of pancreatic cancer with a worse prognosis than pancreatic ductal adenocarcinoma. The authors report on a retrospective study of 13 patients diagnosed with ASC in an integrated health care system. Methods A retrospective review was performed of all patients with pancreatic cancer identified between February 2010 and December 2018. Twenty-three patients were diagnosed with pancreatic ASC. Patient demographics, tumor characteristics, treatment modalities, and median survival were evaluated. Results Median overall survival was 8 months (standard devision [SD] = 18.6). Eight out of 13 patients who received surgery upfront had a positive surgical margin (62%). Eleven patients received adjuvant therapy. Median survival for patients who received multimodal treatment was 57 months (SD = 5.7) compared with 2.5 months for patients who received only surgery. Median survival for patients with negative pathologic margins was 17 months (SD = 23.6). One patient was receiving neoadjuvant chemotherapy (6 months into treatment without any evidence of metastatic disease). Discussion The high proportion of positive surgical margins and large tumor size upon presentation suggest that primary tumor downstaging should be considered. The positive results from recent prospective trials on neoadjuvant chemoradiation for pancreatic ductal adenocarcinoma could be a promising foundation of information for the treatment of ASC. Conclusion ASC of the pancreas is an extremely aggressive malignancy with poor prognosis. Further work is needed to determine the optimal multimodal treatment regimen.
Competing Interests: Conflicts of InterestNone declared
Databáze: MEDLINE
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