Qin Wen-Xing, Wu Ying, Liu Jun, Qin Bao-Dong, Liu Ke, Jiao Xiao-Dong, Wang Zhan, Chen Wan-Sheng, Zang Yuan-Sheng
Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China.
Gland Surg. 2021 Mar;10(3):1029-1037. doi: 10.21037/gs-20-317.
Primary squamous cell carcinoma of pancreas (SCCP) is an extremely rare pathological subtype of pancreatic cancer of ductal origin. Due to its rarity, most previous studies on SCCP focused on case reports or series and the clinio-pathological characteristics of SCCP patients remain unclear.
A retrospective analysis of SCCP patients registered in the Surveillance, Epidemiology and End Results (SEER) database from 1988 to 2016 were performed, and clinical characteristics and prognosis of these patients were also further determined.
A total of 373 patients diagnosed with SCCP were identified. Most SCCP patients 154/243 (63.4%) SCCP patients had distant metastases. The prognosis of SCCP patients was poor with a median overall survival (mOS) of only 3.0 months (95% CI, 2.0-5.0). The 6-month, 1-year and 2-years survival rate were 25.6%, 13.2% and 5.7%, respectively. The prognosis of SCCP patients became much worse with the increasing age (P=0.01) and distant metastases (P<0.01). Cancer-directed surgery, chemotherapy and radiotherapy could significantly prolong the survival time for SCCP patients (P<0.01 for all). Multivariate Cox analysis showed that only distant metastases were independent prognostic factors of worse survival in SCCP patients (HR =1.58, 95% CI, 1.18-2.12). Conversely, both cancer-directed surgery and chemotherapy were an independent protective factor that decreased the risk of death by 66% (HR =0.18, 95% CI, 0.11-0.29) and 46% (HR =0.54, 95% CI, 0.43-0.68) for SCCP patients.
SCCP is a rare type of pancreatic malignancies with poor prognosis. The present study could provide some useful information for future management and prospective studies for SCCP patients.
胰腺原发性鳞状细胞癌(SCCP)是一种极为罕见的导管源性胰腺癌病理亚型。由于其罕见性,既往大多数关于SCCP的研究集中于病例报告或病例系列,SCCP患者的临床病理特征仍不明确。
对1988年至2016年监测、流行病学和最终结果(SEER)数据库中登记的SCCP患者进行回顾性分析,并进一步确定这些患者的临床特征和预后。
共识别出373例诊断为SCCP的患者。大多数SCCP患者(154/243,63.4%)发生远处转移。SCCP患者预后较差,中位总生存期(mOS)仅为3.0个月(95%CI,2.0 - 5.0)。6个月、1年和2年生存率分别为25.6%、13.2%和5.7%。SCCP患者的预后随着年龄增长(P = 0.01)和远处转移(P < 0.01)而显著变差。针对癌症的手术、化疗和放疗可显著延长SCCP患者的生存时间(均P < 0.01)。多因素Cox分析显示,仅远处转移是SCCP患者生存较差的独立预后因素(HR = 1.58,95%CI,1.18 - 2.12)。相反,针对癌症的手术和化疗均是独立的保护因素,可使SCCP患者的死亡风险分别降低66%(HR = 0.18,95%CI,0.11 - 0.29)和46%(HR = 0.54,95%CI,0.43 - 0.68)。
SCCP是一种预后较差的罕见胰腺恶性肿瘤。本研究可为SCCP患者未来的管理和前瞻性研究提供一些有用信息。