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Long-term survival after resection of sarcomatoid carcinoma of the pancreas: an updated experience. J Surg Res 2017 Nov;219:238-243

Date

10/29/2017

Pubmed ID

29078888

Pubmed Central ID

PMC6178816

DOI

10.1016/j.jss.2017.05.065

Scopus ID

2-s2.0-85021656418   7 Citations

Abstract

BACKGROUND: Sarcomatoid carcinoma of the pancreas (SCP) is a rare histologic subtype of undifferentiated pancreatic carcinoma. Historically, this has been associated with a worse overall prognosis than adenocarcinoma. However, the clinical course and surgical outcomes of SCP remain poorly characterized owing to its rarity.

METHODS: A single-institution, prospectively maintained database was queried for patients who underwent pancreatic resection with a final diagnosis of SCP. We describe their histology, clinicopathologic features, and perioperative outcomes. Survival data are highlighted, and common traits of long-term survivors are examined.

RESULTS: Over a 25-year period, 7009 patents underwent pancreatic resection at our institution. Eight (0.11%) were diagnosed with SCP on final histopathology. R0 resection was achieved in six patients (75%). Four patients had early recurrence leading to death (<3 months). Two (25%) experienced long-term survival (>5 years), with the longest surviving nearly 16 years despite the presence of lymph node metastasis. There were no deaths attributed to perioperative complications. Both long-term survivors had disease in the body/tail of the pancreas and received adjuvant radiotherapy. One also received adjuvant gemcitabine-based chemotherapy.

CONCLUSIONS: SCP is a rarely appreciated subset of pancreatic malignancy that does not necessarily portend to a uniformly dismal prognosis. Although some have rapid recurrence and an early demise, long-term survival may be possible. Future studies are needed to better define the cohort with potential for long-term survival so that aggressive therapies may be tailored appropriately in this patient subset.

Author List

Blair AB, Burkhart RA, Griffin JF, Miller JA, Weiss MJ, Cameron JL, Wolfgang CL, He J

Author

James Adam Miller MD, MPH Assistant Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Baltimore
Carcinoma
Female
Humans
Male
Middle Aged
Pancreas
Pancreatic Neoplasms
Retrospective Studies