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Clinical and Histological Basis of Adenosquamous Carcinoma of the Pancreas: A 30-year Experience
- Source :
- J Surg Res
- Publication Year :
- 2020
-
Abstract
- Background Adenosquamous carcinoma (ASC) of the pancreas is a rare form of malignancy with a poor prognosis. We herein report our case series with review of the contemporary literature. Methods With institutional review board approval, we identified 23 patients with pancreatic ASC. Results ASC was more common in women (61%), with a median age of 73 y at presentation. The tumor was in the head of the pancreas in 65% of cases. Six cases (26%) had resectable disease, three (13%) were borderline resectable, and eight (34.7%) were locally advanced or metastatic. First-line treatment included pancreatic resection in eight cases (34.8%), concurrent neoadjuvant chemoradiation in three (13%), and neoadjuvant chemotherapy in two (8.7%). Most resected tumors had pathological T3 stage (80%). Pathological nodal disease was demonstrated in 60%, and margins were positive in three cases. Complete pathological response was not observed, although fibrosis presented in only one case (10%). Eventually, twenty patients developed metastatic disease. Overall survival is 11.5 [95% confidence interval 6, 14.5] months. Conclusions ASC demonstrates a more aggressive malignant phenotype and carries a worse prognosis. Oncological resection is the mainstay of treatment. Neoadjuvant chemoradiation is an emerging approach in the management of ASC that has been extrapolated from the adenocarcinoma neoadjuvant trials.
- Subjects :
- Male
medicine.medical_specialty
Adenosquamous carcinoma
medicine.medical_treatment
Malignancy
Disease-Free Survival
Article
03 medical and health sciences
Carcinoma, Adenosquamous
0302 clinical medicine
Pancreatectomy
Antineoplastic Combined Chemotherapy Protocols
Medicine
Humans
Stage (cooking)
Pathological
Pancreas
Neoadjuvant therapy
Aged
Neoplasm Staging
business.industry
Chemoradiotherapy, Adjuvant
Middle Aged
Institutional review board
medicine.disease
Prognosis
Neoadjuvant Therapy
Pancreatic Neoplasms
medicine.anatomical_structure
Treatment Outcome
Chemotherapy, Adjuvant
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Adenocarcinoma
030211 gastroenterology & hepatology
Surgery
Female
Radiology
Neoplasm Recurrence, Local
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 10958673
- Volume :
- 259
- Database :
- OpenAIRE
- Journal :
- The Journal of surgical research
- Accession number :
- edsair.doi.dedup.....11f64757b3f18345aee95eb8e568ac1c