Clinical characteristics and surgical outcomes of resectable acinar cell carcinoma of the pancreas-propensity score matching analysis with pancreatic ductal adenocarcinoma |
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| Institution: | 1. Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, UK;2. Institute of Immunology and Immunotherapy, University of Birmingham, UK;3. Institute of Cancer and Genomic Science, University of Birmingham, UK;4. Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, UK;5. Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;6. Department of Pathology, San Bortolo Hospital, Vicenza, Italy;1. Division of Colorectal Surgery, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;2. Department Radiodiagnosis, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;3. Department of Medical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;1. Washington Cancer Institute, Program in Peritoneal Surface Malignancy Washington, DC, USA;2. Westat, Rockville, MD, USA;1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China;2. Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China;1. Department of Nuclear Medicine, Tata Memorial Hospital and Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, 400012, India;2. Division of Colorectal Surgery, Department of Surgical Oncology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;3. Department of Medical Gastroenterology, Tata Memorial Hospital and Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India;4. Department of Radiation Oncology, Tata Memorial, Hospital and Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, 400012, India;1. Department of General Surgery, Guy''s and St Thomas'' NHS Trust, London, UK;2. Department of General Surgery, Queen Alexandra Hospital, Portsmouth University Hospital NHS Trust, Portsmouth, UK;3. Department of General Surgery, Oxford University Hospital NHS Foundation Trust, Oxford, UK;4. School of Cancer Sciences, Faculty of Medicine, University of Southampton, UK;5. School of Cancer and Pharmaceutical Sciences, King''s College London, London, UK;6. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden |
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| Abstract: | BackgroundSurgical resection is recommended for patients with resectable acinar cell carcinoma (ACC). The aim of this study was to investigate the clinical characteristics and surgical outcomes of resectable ACC in comparison to pancreatic ductal adenocarcinoma (PDAC).MethodA retrospective analysis was performed on all patients who consecutively underwent radical resection with pathologically confirmed ACC and PDAC from December 2011 to December 2018. Clinicopathologic characteristics and follow-up information were analyzed. A 1:3 propensity score matching (PSM) method was used to minimize the bias between ACC and PDAC.ResultsA total of 26 patients with ACC and 1351 with PDAC were included. Compared to PDAC, ACC tended to be larger (4.5 vs. 3.0 cm; p < 0.001) and more frequently located in the pancreatic body/tail (61.5% vs. 36.6%, p = 0.009), with lower total bilirubin levels, lower neutrophil lymphocyte ratio (NLR) levels and lower carbohydrate antigen 19-9 (CA19-9) levels and carcinoembryonic antigen (CEA) levels. There was no difference in postoperative morbidities in patients with ACC and PDAC. The median OS and RFS were longer in ACC when compared to PDAC (OS: 43.5 mo vs. 19.0 mo, p = 0.004; RFS: 24.5 mo vs. 11.6 mo, p = 0.023). After the 1:3 PSM, ACC remained to be a better histological type for OS (p = 0.024), but had comparable RFS with PDAC (p = 0.164).ConclusionPatients with ACC after radical resection had better OS than that with PDAC. However, ACC is also an aggressive tumor with a similar trend of RFS with PDAC after the matching, necessitating the multidisciplinary treatment for resectable ACC disease. |
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| Keywords: | Acinar cell carcinoma Pancreatic ductal adenocarcinoma Surgical resection Propensity score matching |
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