Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors
Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors
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DOI：
10.1200/jco.2002.02.005
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发表时间：
2002-12-15
影响因子：
45.3
通讯作者：
Saltz, LB
中科院分区：
文献类型：
--
作者：
Holen, KD;Klimstra, DS;Saltz, LB
目的：腺泡细胞癌是一种罕见的胰腺外分泌肿瘤。预后信息、生存率和治疗结果等临床特征尚不清楚。我们进行了迄今为止最大规模的回顾性综述。患者和方法：1981 年 8 月至 2001 年 1 月期间，确定了 39 名经病理证实的胰腺腺泡肿瘤患者。通过图表审查获得了人口统计数据、肿瘤特征和治疗信息。使用 Kaplan-Meier 方法估计生存概率，并使用对数秩检验进行比较。结果：所有患者的中位生存期为 19 个月。根据单变量分析，患者的疾病阶段与生存率显着相关。患有局部疾病的患者的中位生存期为 38 个月，而出现转移的患者的中位生存期为 14 个月 (P=0.03)。与未接受手术的患者（14 个月）相比，可以接受手术作为一线治疗的患者的生存时间（36 个月）更长。 18 名接受化疗的患者中的 2 名和 8 名接受放疗的患者中的 3 名出现了主要反应。 结论：生存曲线表明，这是一种比胰腺内分泌肿瘤更具侵袭性的癌症，但比胰腺导管腺癌的侵袭性更弱。那些出现局部疾病的患者比那些出现转移的患者预后要好得多。完全手术切除后复发率很高，这表明即使在局部疾病中也存在微转移，并且可能需要辅助治疗。然而，化疗和放疗的结果令人失望，因此需要新的疗法。
Purpose: Acinar cell carcinoma is a rare tumor of the exocrine pancreas. Clinical features such as prognostic information, survival, and treatment outcomes are unknown. We present the largest retrospective review to date.Patients and Methods: Thirty-nine patients with pathologically confirmed acinar neoplasms of the pancreas were identified between August 1981 and January 2001. Demographic data, tumor characteristics, and treatment information were obtained by chart review. Survival probabilities were estimated by using the Kaplan-Meier method and compared using the log-rank test.Results: The median survival for all patients was 19 months. On the basis of a univariate analysis, the patients' stage of disease correlated significantly with survival. The median survival of patients with localized disease was 38 months, versus 14 months for those presenting with metastases (P=0.03). Patients who could be treated with surgery as first-line therapy had a longer survival time (36 months) compared with those who did not have surgery (14 months). Two of 18 patients who received chemotherapy and three of eight patients who received radiation had a major response.Conclusion: The survival curves suggest a more aggressive cancer than pancreatic endocrine neoplasms but one that is less aggressive than ductal adenocarcinoma of the pancreas. Those patients who present with localized disease have a much better prognosis than those who present with metastases. There is a high recurrence rote after complete surgical resection, suggesting that micrometastases are present even in localized disease and that adjuvant therapies may be indicated. Chemotherapy and radiation afford disappointing results, however, and novel therapies are needed.