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Long-term outcomes after an aggressive resection of adenosquamous carcinoma of the pancreas

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Abstract

Purpose

Adenosquamous carcinoma (ASC) of the pancreas is a rare malignancy, associated with a poor prognosis after surgical resection, with reported median survival times (MSTs) ranging from 4.4 to 13.1 months. We conducted this study to investigate the long-term outcomes of patients after the resection for ASC.

Methods

Between 2002 and 2016, a total of 456 patients underwent resection for ASC or adenocarcinoma (AC) of the pancreas. ASC was confirmed in 17 (3.7%) of these patients. We analyzed the clinicopathological characteristics and survival of these 17 patients in comparison with those of patients with AC of the pancreas.

Results

The operative procedures performed were pancreaticoduodenectomy (n = 6) and distal pancreatectomy (n = 11). Seven (41.2%) of the 17 patients underwent combined organ resection. R0 resection was achieved in 16 (94.1%) patients. The 5-year overall survival (OS) rate and MST were 40.3% and 20.9 months, respectively. A squamous component of ≥ 60% (P = 0.001) and R1 resection (P < 0.001) were significantly associated with poor OS for patients with ASC

Conclusion

This study revealed longer survival and a higher R0 resection rate after aggressive combined resection in our ASC patients than those in previous studies. Although this was only a small series, our findings suggest that local control with aggressive resection may be an effective treatment protocol for ASC patients.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Takaaki Ito, Teiichi Sugiura, Yukiyasu Okamura, Yusuke Yamamoto, Ryo Ashida, Katsuhisa Ohgi & Katsuhiko Uesaka

  2. Division of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan

    Keiko Sasaki

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  1. Takaaki Ito
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  2. Teiichi Sugiura
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  3. Yukiyasu Okamura
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  4. Yusuke Yamamoto
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Correspondence to Takaaki Ito.

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Takaaki Ito and his co-authors have no conflicts of interest to declare.

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Ito, T., Sugiura, T., Okamura, Y. et al. Long-term outcomes after an aggressive resection of adenosquamous carcinoma of the pancreas. Surg Today 49, 809–819 (2019). https://doi.org/10.1007/s00595-019-01807-8

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  • DOI: https://doi.org/10.1007/s00595-019-01807-8

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