Liu Xinchun, Wang Haoran, Ying Rongchao
Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of General Surgery, The Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Transl Cancer Res. 2022 Jul;11(7):2061-2069. doi: 10.21037/tcr-22-410.
Sarcomatoid carcinoma (SCP) and carcinosarcoma (CSP) of the pancreas are extremely rare entities and little is known about their characteristics. Using a population-based cancer registry, we aimed at improving our understanding of these entities with a focus on the comparison between these two entities.
Patients with SCP or CSP were identified through the Surveillance Epidemiology and End Results (SEER) database. Demographic and clinical characteristics were collected and compared. Survival was compared using the Kaplan-Meier method and analyzed using the log-rank test and Cox proportional hazards models.
A total of 85 patients with SCP and 32 patients with CSP were included in the study. There was no difference in the patient age, race distribution, year of diagnosis, primary site, tumor size, tumor stage, receipt of chemotherapy and receipt of radiotherapy between the two groups. However, more patients with CSP received surgical treatment (P<0.001) when compared to patients with SCP. Overall survival was comparable between the two groups (P=0.562) with a 1-year survival rate of 20.8% and 22.2% for SCP and CSP, respectively. Multivariate analysis showed that surgical resection was independent prognostic factor of both SCP (HR: 0.34, P=0.017) and CSP (HR: 0.17, P=0.017). Chemotherapy was a prognostic factor of CSP in univariate analysis, but not of SCP.
SCP and CSP are rare malignant tumors of the pancreas with a dismal prognosis. Surgical resection was the common prognostic factor and was recommended when possible.
胰腺肉瘤样癌（SCP）和癌肉瘤（CSP）极为罕见，对其特征了解甚少。我们利用基于人群的癌症登记系统，旨在加深对这些实体的认识，重点是比较这两种实体。
通过监测、流行病学和最终结果（SEER）数据库识别出SCP或CSP患者。收集并比较人口统计学和临床特征。使用Kaplan-Meier方法比较生存率，并使用对数秩检验和Cox比例风险模型进行分析。
本研究共纳入85例SCP患者和32例CSP患者。两组患者的年龄、种族分布、诊断年份、原发部位、肿瘤大小、肿瘤分期、化疗接受情况和放疗接受情况均无差异。然而，与SCP患者相比，CSP患者接受手术治疗的更多（P<0.001）。两组的总生存率相当（P=0.562），SCP和CSP的1年生存率分别为20.8%和22.2%。多变量分析显示，手术切除是SCP（HR：0.34，P=0.017）和CSP（HR：0.17，P=0.017）两者的独立预后因素。化疗在单变量分析中是CSP的预后因素，但不是SCP的预后因素。
SCP和CSP是罕见的胰腺恶性肿瘤，预后不佳。手术切除是常见的预后因素，尽可能推荐手术。
