Adenosquamous Versus Adenocarcinoma of the Pancreas: A Population-Based Outcomes Analysis
Pancreatic adenosquamous carcinoma has historically been characterized as having a more aggressive clinical course than ductal adenocarcinoma. The natural history of this disease, however, is essentially unknown.
We evaluated the clinical characteristics of all patients with pancreatic adenosquamous carcinoma recorded in the California Cancer Registry 2000–2007 and compared them to those of patients with ductal adenocarcinoma.
Ninety-five patients with pancreatic adenosquamous carcinoma and 14,746 patients with ductal adenocarcinoma were identified. Demographics were similar between subtypes (p > 0.05). Disease stage at presentation was also similar; over 50% of each diagnostic group presented with metastatic disease (p = 0.62). Surgical resection was more common among patients with locoregional adenosquamous carcinoma than adenocarcinoma (p = 0.0004), but rates of adjuvant therapy administration were similar (p > 0.05). The cohorts’ median overall survival durations were similar in a Cox proportional hazards model (p = 0.45); overall survival was also similar when only patients with resected disease were considered (p = 0.65). Early stage, resection and receipt of radiation or chemotherapy were favorable independent prognostic factors among patients with adenosquamous carcinoma. The median overall survival duration of patients with resected adenosquamous carcinoma was 12 months (95% CI, 8–52).
Adenosquamous carcinoma has a natural history similar to that of ductal adenocarcinoma when treated with prevalent clinical patterns of care.
- Cihak RW, Kawashima T, Steer A. Adenoacanthoma (adenosquamous carcinoma) of the pancreas. Cancer 1972; 29(5):1133–40. CrossRef
- Madura JA, Jarman BT, Doherty MG, et al. Adenosquamous carcinoma of the pancreas. Arch Surg 1999; 134(6):599–603. CrossRef
- Hruban R, Pitman M, Klimstra D. Tumors of the pancreas. In Silverberg S, Sobin L, eds. AFIP Atlas of Tumor Pathology. Washington, DC: American Registry of Pathology, 2007. pp. 177–81.
- Katz MH, Wang H, Fleming JB, et al. Long-term survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol 2009; 16(4):836–47. CrossRef
- Hsu JT, Chen HM, Wu RC, et al. Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma. World J Surg Oncol 2008; 6:95. CrossRef
- Okabayashi T, Hanazaki K. Surgical outcome of adenosquamous carcinoma of the pancreas. World J Gastroenterol 2008; 14(44):6765–70. CrossRef
- Smoot RL, Zhang L, Sebo TJ, Que FG. Adenosquamous carcinoma of the pancreas: a single-institution experience comparing resection and palliative care. J Am Coll Surg 2008; 207(3):368–70. CrossRef
- Skafida E, Grammatoglou X, Glava C, et al. Adenosquamous carcinoma of the pancreas: a case report. Cases J 2010; 3:41. CrossRef
- Lampropoulos P, Filippou G, Skafida E, et al. Adenosquamous carcinoma of the pancreas, a rare tumor entity: a case report. Cases J 2009; 2:9129. CrossRef
- Kobayashi N, Higurashi T, Iida H, et al. Adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM). J Hepatobiliary Pancreat Surg 2008; 15(5):531–5. CrossRef
- Jamali M, Serra S, Chetty R. Adenosquamous carcinoma of the pancreas with clear cell and rhabdoid components. A case report. JOP 2007; 8(3):330–4.
- Alwaheeb S, Chetty R. Adenosquamous carcinoma of the pancreas with an acantholytic pattern together with osteoclast-like and pleomorphic giant cells. J Clin Pathol 2005; 58(9):987–90. CrossRef
- Inoue T, Nagao S, Tajima H, et al. Adenosquamous pancreatic cancer producing parathyroid hormone-related protein. J Gastroenterol 2004; 39(2):176–80. CrossRef
- Murakami Y, Yokoyama T, Yokoyama Y, et al. Adenosquamous carcinoma of the pancreas: preoperative diagnosis and molecular alterations. J Gastroenterol 2003; 38(12):1171–5. CrossRef
- Yamaue H, Tanimura H, Onishi H, et al. Adenosquamous Carcinoma of the Pancreas: Successful Treatment with Extended Radical Surgery, Intraoperative Radiation Therapy, and Locoregional Chemotherapy. Int J Gastrointest Cancer 2001; 29(1):53–58. CrossRef
- Yavuz E, Kapran Y, Ozden I, et al. Pancreatobiliary adenosquamous carcinoma (report of two cases). Pathologica 2000; 92(5):323–6.
- Komatsuda T, Ishida H, Konno K, et al. Adenosquamous carcinoma of the pancreas: report of two cases. Abdom Imaging 2000; 25(4):420–3. CrossRef
- Aranha GV, Yong S, Olson M. Adenosquamous carcinoma of the pancreas. Int J Pancreatol 1999; 26(2):85–91. CrossRef
- Nabae T, Yamaguchi K, Takahata S, et al. Adenosquamous carcinoma of the pancreas: report of two cases. Am J Gastroenterol 1998; 93(7):1167–70. CrossRef
- Lozano MD, Panizo A, Sola IJ, Pardo-Mindan FJ. FNAC guided by computed tomography in the diagnosis of primary pancreatic adenosquamous carcinoma. A report of three cases. Acta Cytol 1998; 42(6):1451–4.
- Myung SJ, Kim MH, Lee SK, et al. Adenosquamous carcinoma of the pancreas: differentiation from pancreatic pseudocyst. Gastrointest Endosc 1998; 47(5):410–3. CrossRef
- Kuji I, Sumiya H, Taki J, et al. Intense Ga-67 uptake in adenosquamous carcinoma of the pancreas. Ann Nucl Med 1997; 11(1):41–3. CrossRef
- Campman SC, Fajardo MA, Rippon MB, et al. Adenosquamous carcinoma arising in a mucinous cystadenoma of the pancreas. J Surg Oncol 1997; 64(2):159–62. CrossRef
- Onoda N, Kang SM, Sugano S, et al. Mucoepidermoid carcinoma of the pancreas: report of a case. Surg Today 1995; 25(9):843–7. CrossRef
- Makiyama K, Takuma K, Zea-Iriarte WL, et al. Adenosquamous carcinoma of the pancreas. J Gastroenterol 1995; 30(6):798–802. CrossRef
- Tanaka N, Ohoida J, Matuno T, et al. Response of adenosquamous carcinoma of the pancreas to interferon-alpha, tumor necrosis factor-alpha and 5-fluorouracil combined treatment. Anticancer Res 1994; 14(6B):2739–42.
- Voong KR, Davison J, Pawlik TM, et al. Resected pancreatic adenosquamous carcinoma: clinicopathologic review and evaluation of adjuvant chemotherapy and radiation in 38 patients. Hum Pathol 2008; 41(1):113–22. CrossRef
- Rahemtullah A, Misdraji J, Pitman MB. Adenosquamous carcinoma of the pancreas: cytologic features in 14 cases. Cancer 2003; 99(6):372–8. CrossRef
- Kardon DE, Thompson LD, Przygodzki RM, Heffess CS. Adenosquamous carcinoma of the pancreas: a clinicopathologic series of 25 cases. Mod Pathol 2001; 14(5):443–51. CrossRef
- Motojima K, Tomioka T, Kohara N, et al. Immunohistochemical characteristics of adenosquamous carcinoma of the pancreas. J Surg Oncol 1992; 49(1):58–62. CrossRef
- Yamaguchi K, Enjoji M. Adenosquamous carcinoma of the pancreas: a clinicopathologic study. J Surg Oncol 1991; 47(2):109–16. CrossRef
- California Department of Health Services (1997) Cancer reporting in California: standards for automated reporting volume II. California Department of Health Services, Sacramento
- California Department of Health Services (1997) Cancer reporting in California: standards for automated reporting volume III. California Department of Health Services, Sacramento
- Seiffert JE, Price WT, Gordon B. The California tumor registry: a state-of-the-art model for a regionalized, automated, population-based registry. Top Health Rec Manage 1990; 11(2):59–73.
- How complete are California Cancer Registry data? Retrieved March 9, 2010 from: http://www.ccrcal.org/questions.html#how%20complete%20is%20ccr%20data. The entry was published in 2007.
- Tucker T, Howe H, Weir H. Certification for population-based cancer registries. J Registry Manage 1999; 26:24–27.
- Fritz A, Percy C, Jack A, et al. International classification of diseases for oncology (ICD-O). Geneva: World Health Organization, 2000.
- Zell JA, Rhee JM, Ziogas A, et al. Race, socioeconomic status, treatment, and survival time among pancreatic cancer cases in California. Cancer Epidemiol Biomarkers Prev 2007; 16(3):546–52. CrossRef
- Yost K, Perkins C, Cohen R, et al. Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 2001; 12(8):703–11. CrossRef
- Katz MH, Hwang R, Fleming JB, Evans DB. Tumor-node-metastasis staging of pancreatic adenocarcinoma. CA Cancer J Clin 2008; 58(2):111–25. CrossRef
- Brody JR, Costantino CL, Potoczek M, et al. Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma. Mod Pathol 2009; 22(5):651–9. CrossRef
- Hsu JT, Yeh CN, Chen YR, et al. Adenosquamous carcinoma of the pancreas. Digestion 2005; 72(2–3):104–8. CrossRef
- Baylor SM, Berg JW. Cross-classification and survival characteristics of 5,000 cases of cancer of the pancreas. J Surg Oncol 1973; 5(4):335–58. CrossRef
- Fitzgerald TL, Hickner ZJ, Schmitz M, Kort EJ. Changing incidence of pancreatic neoplasms: a 16-year review of statewide tumor registry. Pancreas 2008; 37(2):134–8. CrossRef
- NCCN Clinical Practice Guidelines in Oncology: Pancreatic adenocarcinoma. Retrieved March 9, 2010 from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. The entry was published in 2009.
- Krishnan S, Rana V, Janjan NA, et al. Prognostic factors in patients with unresectable locally advanced pancreatic adenocarcinoma treated with chemoradiation. Cancer 2006; 107(11):2589–96. CrossRef
- Field RW, Smith BJ, Platz CE, et al. Lung cancer histologic type in the surveillance, epidemiology, and end results registry versus independent review. J Natl Cancer Inst 2004; 96(14):1105–7. CrossRef
- Henson DE, Albores-Saavedra J. Checking up on the surveillance, epidemiology, and end results program. J Natl Cancer Inst 2004; 96(14):1050–1. CrossRef
- Adenosquamous Versus Adenocarcinoma of the Pancreas: A Population-Based Outcomes Analysis
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Journal of Gastrointestinal Surgery
Volume 15, Issue 1 , pp 165-174
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- Author Affiliations
- 1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, TX, 77030, USA
- 2. Department of Epidemiology, University of California at Irvine, Irvine, CA, USA
- 3. Department of Surgery, University of Minnesota and Minneapolis VAMC, Minneapolis, MN, USA
- 4. Department of Surgery, University of California at Irvine, Orange, CA, USA
- 5. Department of Medicine, Division of Hematology/Oncology, University of California at Irvine, Orange, CA, USA