Survival Outcomes of Acinar Cell Pancreatic Cancer

Abstract

Objectives: Acinar cell pancreatic carcinomas (ACPCs) are rare neoplasms accounting for 1% to 2% of pancreatic tumors in adults. The objective of this study is to evaluate the benefit of chemotherapy in the adjuvant setting in resected ACPC and in the palliative setting for metastatic ACPC.Methods: Data were obtained from all US hospitals that contributed to the National Cancer Database between 2004 and 2014. Cases were identified using the histology code 8550.Results: A total of 593 patients with ACPC were identified. The mean age was 64.4 years (range, 18-90 years), with a male preponderance (72.8%, n = 432). Localized stage disease comprised 52.3% (n = 310) of patients. Among localized ACPC patients, 88.0% (n = 191) underwent surgery and 50.6% (n = 91) received adjuvant chemotherapy. The 5-year overall survival in those who received adjuvant treatment was slightly higher than those who did not receive adjuvant treatment (46.7% vs 44.8%, P = 0.3271). Among advanced-stage ACPC patients, 67.6% received chemotherapy, which translated into improved 5-year overall survival compared with no chemotherapy (8.1% vs 0%, P < 0.0001).Conclusions: Chemotherapy in the palliative setting for advanced-stage ACPC patients was associated with improved survival. Adjuvant therapy did not translate into significant survival benefit.

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

“…Although radical surgery is recommended for patients with PACC who do not have distant metastases, the recurrence rate is high ( 12 , 19 , 88–90 ). The 5-year survival rate of Stage IV patients was not significantly different between patients who underwent surgery and those who did not ( 13 ). Evidence is accumulating regarding the effectiveness of surgical resection for oligometastasis in patients with PDAC ( 91–95 ).…”

“…In a multicenter retrospective analysis of chemotherapy in 58 patients with advanced PACC, 69% were male, and the median age was 60.5 years ( 11 ). In the United States, a national cancer database analysis (593 patients with PACC) showed that 72.8% of the patients were male, and the mean age was 64.4 years ( 13 ). In a retrospective analysis of German cancer registry group (233 patients with PACC), the median age was significantly lower, and the percentage of males was significantly higher in patients with PACC than in those with PDAC ( 14 ).…”

“…Computed tomography (CT) is more sensitive for detecting calcifications, whereas magnetic resonance imaging is more effective for detecting intratumoral haemorrhage, tissue invasion and pancreatic duct dilation ( 24 , 40 ). Approximately 30–50% of patients with PACC have metastatic disease at the time of presentation ( 4 , 13 , 14 ). Takahashi et al.…”

“…Although the benefit of adjuvant treatment has been demonstrated in patients with PDAC ( 97–99 ), the benefit of adjuvant treatment in patients with PACC is unclear ( 1 , 13 , 14 , 27 , 32 , 100–102 ). Two recent multicenter studies demonstrated that 52.5–62.7% of patients who underwent adjuvant treatment did not show any survival benefit of adjuvant treatment, and more than 50% of the patients experienced recurrence after surgery ( 25 , 26 ).…”