Referral and treatment patterns in pancreatic acinar cell carcinoma: A regional population-level analysis - 17/04/24

Doi : 10.1016/j.amjsurg.2023.04.010

Ranish K. Patel ^a, Michael Parappilly ^b, Thomas L. Sutton ^a, Shay Behrens ^a, Issac R. Schwantes ^a, Alicia J. Johnson ^a, Rodney F. Pommier ^c, Brett C. Sheppard ^a,^⁎
^a Oregon Heath & Science University (OHSU), Department of Surgery, Division of General Surgery, Portland, OR, 97239, USA
^b Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA
^c OHSU Department of Surgery, Division of Surgical Oncology, Knight Cancer Institute, Portland, OR, 97239, USA

^∗Corresponding author. Oregon Health & Science University, USA.Oregon Health & Science UniversityUSA

Abstract

Background

Pancreatic acinar cell carcinoma (PACC) is a rare exocrine tumor of the pancreas. We evaluated the effect disease stage, surgical intervention, and institutional volume status plays in survival.

Methods

We queried the Oregon State Cancer Registry for patients with PACC from 1997 to 2018. Treatment and referral patterns were analyzed, and overall survival (OS) was evaluated with Kaplan-Meier and Cox-proportional hazard analysis.

Results

43 patients were identified. Median OS was 33.1 and 7.1 months in those with locoregional and metastatic disease respectively (p = 0.008). Surgical intervention was associated with improved OS (hazard ratio 0.28, p < 0.0001). High volume center (HVC) care trended towards improving OS. While the majority of cases were diagnosed at low volume centers (74%), referral to HVCs was rare (n = 4) and limited to advanced (stage III/IV) disease.

Conclusion

Stage and surgical resection influence survival outcomes in PACC, more data is needed to delineate the impact of institutional volume status.

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Highlights

•	Pancreatic acinar cell carcinoma (PACC) is a rare exocrine pancreatic malignancy.
•	PACC carries an improved prognosis compared to pancreatic ductal adenocarcinoma.
•	Surgical resection and disease stage impact survival in PACC.
•	The impact of institutional volume status on survival remains unclear.

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Keywords : Survival, Treatment patterns, Referral center, Acinar cell carcinoma, Pancreas, Surgical resection

Plan

Introduction

Materials and methods

Study population and patient data

Statistical analysis

Results

Demographics

Clinical and surgical characteristics

Survival characteristics

Discussion

Conclusions

Funding

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Vol 231

P. 55-59 - mai 2024 Retour au numéro

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Referral and treatment patterns in pancreatic acinar cell carcinoma: A regional population-level analysis - 17/04/24

Abstract

Background

Methods

Results

Conclusion

Highlights

Plan

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