Clinical Characteristics and Overall Survival in Patients with Anaplastic Pancreatic Cancer

• Published in: The American surgeon Vol. 80; no. 2; pp. 117 - 123
• Main Authors: Clark, Clancy J., Arun, Janani S., Graham, Rondell P., Zhang, Lizhi, Farnell, Michael, Reid-Lombardo, Kaye M.
• Format: Journal Article
• Language: English
• Published: United States SAGE PUBLICATIONS, INC 01.02.2014
• Subjects: Academic Medical Centers; Age Factors; Aged; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - surgery; Carcinoma, Pancreatic Ductal - mortality; Carcinoma, Pancreatic Ductal - pathology; Carcinoma, Pancreatic Ductal - surgery; Case-Control Studies; Cause of Death; Female; Hospital Mortality - trends; Humans; Kaplan-Meier Estimate; Male; Medical prognosis; Middle Aged; Minnesota; Mortality; Neoplasm Invasiveness - pathology; Neoplasm Staging; Pancreas; Pancreatectomy - methods; Pancreatectomy - mortality; Pancreatic cancer; Pathology; Reference Values; Retrospective Studies; Risk Assessment; Sex Factors; Statistics, Nonparametric; Studies; Survival Analysis; Minnesota
• ISSN: 0003-1348; 1555-9823; 1555-9823
• DOI: 10.1177/000313481408000218

Anaplastic pancreatic cancer (APC) is a rare undifferentiated variant of pancreatic ductal adenocarcinoma with poor overall survival (OS). The aim of this study was to evaluate the clinical outcomes of APC compared with differentiated pancreatic ductal adenocarcinoma. We conducted a retrospective review of all patients treated at the Mayo Clinic with pathologically confirmed APC from 1987 to 2011. After matching with control subjects with pancreatic ductal adenocarcinoma, OS was evaluated using Kaplan-Meier estimates and log-rank test. Sixteen patients were identified with APC (56.3% male, median age 57 years). Ten patients underwent exploration of whom eight underwent pancreatectomy. Perioperative morbidity was 60 per cent with no mortality. The median OS was 12.8 months. However, patients with APC who underwent resection had longer OS compared with those who were not resected, 34.1 versus 3.3 months ( P = 0.001). After matching age, sex, tumor stage, and year of operation, the median OS was similar between patients with APC and those with ductal adenocarcinoma treated with pancreatic resection, 44.1 versus 39.9 months, ( P = 0.763). Overall survival for APC is poor; however, when resected, survival is similar to differentiated pancreatic ductal adenocarcinoma.