415 patients with adenosquamous carcinoma of the pancreas: a population-based analysis of prognosis and survival.
415 patients with adenosquamous carcinoma of the pancreas: a population-based analysis of prognosis and survival.
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DOI：
10.1016/j.jss.2011.06.015
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发表时间：
2012-05-01
期刊：
影响因子：
--
通讯作者：
Riall TS
中科院分区：
文献类型：
--
作者：
Boyd CA;Benarroch-Gampel J;Sheffield KM;Cooksley CD;Riall TS
胰腺腺鳞癌是一种罕见的疾病。我们对这种疾病及其预后的了解主要来自小型回顾性研究。使用监测、流行病学和最终结果（SEER）数据库（1988年至2007年），我们确定了胰腺腺鳞癌（N=415）或腺癌（N= 45，693）患者。比较两组的人口统计学资料、肿瘤特征、切除状态和生存率。与腺癌相比，腺鳞癌患者更容易发生胰腺体尾病变（44.6%比53.5%，P<0.0001）。虽然两组的分期分布相似，但腺鳞癌更可能是低分化的（71%对45%，P<0.0001），淋巴结阳性（53%对47%，P<0.0001）和较大的（5.7对4.3 cm，P<0.0001）。对于局部疾病，切除率随着时间的推移从1988年的26%增加到2007年的56%。两组的总2年生存率均为11%。腺鳞癌切除后2年生存率较低（29% vs.36%，P<0.0001）。切除术是局部胰腺腺鳞癌患者生存率最强的独立预测因素（HR 2.35，95%CI =1.47-3.76）。这是第一个以人群为基础的研究，以评估胰腺腺鳞癌的结果。与胰腺癌相比，腺鳞癌更可能发生在胰腺尾部，分化差，体积较大，淋巴结阳性。腺鳞癌手术切除后的长期生存率明显更差;然而，腺鳞癌患者仍然可以从手术切除中获益，这是生存率最强的预测因素。
Adenosquamous carcinoma of the pancreas is rare. Our understanding of the disease and its prognosis comes mainly from small retrospective studies. Using the Surveillance, Epidemiology, and End Results (SEER) database (1988 to 2007), we identified patients with adenosquamous carcinoma (N=415) or adenocarcinoma (N=45,693) of the pancreas. The demographics, tumor characteristics, resection status, and survival were compared between the groups. Compared to patients with adenocarcinoma, patients with adenosquamous carcinoma were more likely to have disease located in the pancreatic body and tail (44.6% vs 53.5%, P<0.0001). While the stage distribution was similar between the two groups, adenosquamous carcinomas were more likely to be poorly differentiated (71% vs 45%, P<0.0001), node positive (53% vs. 47%, P<0.0001), and larger (5.7 vs. 4.3 cm, P<0.0001). For locoregional disease, resection increased over time from 26% in 1988 to 56% in 2007. The overall 2-year survival was 11% in both groups. Following resection, patients with adenosquamous carcinoma had worse 2-year survival (29% vs. 36%, P<0.0001). Resection was the strongest independent predictor of survival for patients with locoregional pancreatic adenosquamous carcinoma (HR 2.35, 95% CI=1.47-3.76). This is the first population-based study to evaluate outcomes in adenosquamous carcinoma of the pancreas. When compared to pancreatic adenocarcinoma, adenosquamous carcinoma was more likely to occur in the pancreatic tail, be poorly differentiated, larger, and node positive. The long-term survival following surgical resection is significantly worse for adenosquamous cancers; however, patients with adenosquamous carcinoma can still benefit from surgical resection, which is the strongest predictor of survival.
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影响因子：
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通讯作者：
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