Shin Sang Hyun, Hwang Ho Kyoung, Jang Jin-Young, Kim Hongbeom, Park Sang Jae, Han Sung-Sik, Han In Woong, Hwang Dae Wook, Heo Jin Seok
Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul 03722, Korea.
Cancers (Basel). 2021 Oct 12;13(20):5095. doi: 10.3390/cancers13205095.
Given the rare incidence of pancreatic acinar cell carcinoma (PACC), its post-resection clinical outcomes remain unclear. Treatment strategies for PACC have relied on those of pancreatic ductal adenocarcinoma (PDAC). The present study retrospectively investigated clinicopathologic characteristics of resected PACC registered in the Korea Tumor Registry System Biliary Pancreas database. Among 59 patients with a mean age of 59.2 years and a male predominance (83.1%), 43, 5, 7, and 4 had pure PACC, ductal differentiations, mixed neuroendocrine carcinomas, and intraductal and papillary variants, respectively. The mean tumor size was 4.6 cm, consisting of eight at T1, 26 at T2, and 25 at T3 stages. Metastasis to regional lymph node was identified in 15 (25.4%) patients. Thirty-one (52.5%) patients received adjuvant therapy. Five-year survival rate was 57.4%. The median survival was 78.8 months. In survival comparison according to the stage with AJCC system, N stage (lymph node metastasis), but not T stage, showed significant differences ( = 0.027). Resected PACC appeared to have clinical outcomes distinct from those of PDAC in this nationwide study. Therefore, large-scale multinational studies are needed to overcome the rarity of PACC and to establish an appropriate treatment strategies and staging system.
鉴于胰腺腺泡细胞癌(PACC)的发病率较低,其切除术后的临床结局仍不明确。PACC的治疗策略一直依赖于胰腺导管腺癌(PDAC)的治疗策略。本研究回顾性调查了韩国肿瘤登记系统胆道胰腺数据库中登记的切除PACC的临床病理特征。在59例平均年龄为59.2岁且男性占优势(83.1%)的患者中,分别有43例、5例、7例和4例患有纯PACC、导管分化型、混合性神经内分泌癌以及导管内和乳头状变异型。平均肿瘤大小为4.6 cm,其中T1期8例,T2期26例,T3期25例。15例(25.4%)患者出现区域淋巴结转移。31例(52.5%)患者接受了辅助治疗。5年生存率为57.4%。中位生存期为78.8个月。根据美国癌症联合委员会(AJCC)系统的分期进行生存比较时,N期(淋巴结转移)而非T期显示出显著差异(P = 0.027)。在这项全国性研究中,切除的PACC似乎具有与PDAC不同的临床结局。因此,需要开展大规模的多国研究,以克服PACC的罕见性,并建立合适的治疗策略和分期系统。