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Adenosquamous carcinoma is a rare form of pancreatic cancer in which at least three tenths of the tumour has turned into squamous cells, the flat cells of skin-like linings. It is found more often in the body and tail, tends to be larger and poorly differentiated, and does worse after surgery than ordinary pancreatic cancer, though surgery remains the strongest predictor of survival.
What it is. The 2019 WHO classification of digestive tumours lists adenosquamous carcinoma as a variant of pancreatic ductal adenocarcinoma in which a squamous component makes up at least 30 percent of the tumour (Nagtegaal 2020); pure squamous cell carcinoma of the pancreas is exceptional and most such tumours prove to be adenosquamous on wider sampling.
How it differs from its parent. In 415 SEER patients (1988 to 2007) compared with 45,693 with adenocarcinoma, adenosquamous tumours were more often in the body and tail, more often poorly differentiated, larger and node positive, and long-term survival after resection was significantly worse, although resection was still the strongest predictor of survival (Boyd 2012). In the National Cancer Database (2004 to 2012), 1,745 adenosquamous carcinomas (1 percent of 207,073 pancreatic cancers) were larger and more often in the body or tail (36 against 24 percent); survival was similar to adenocarcinoma when operated and unoperated patients were pooled, but worse among resected stage I and II patients (Hester 2018).
How common it is. About 1 percent of pancreatic cancers in both US series above; no UK registry count is published.
How it is treated. No trial has been run in this histology. It is staged by the same TNM 8th edition and treated as pancreatic ductal adenocarcinoma: resection with adjuvant chemotherapy when removable, the chemotherapy rows of the parent page when not, with the squamous component sometimes prompting platinum-based regimens by analogy with squamous cancers elsewhere, on case-series evidence only.
About 1 percent of pancreatic cancers: 415 of 46,108 pancreatic carcinomas in SEER (1988 to 2007) and 1,745 of 207,073 in the US National Cancer Database (2004 to 2012). No UK count is published.
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
Same organ: Glucagonoma, VIPoma, Somatostatinoma, Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder cancer, Gallbladder adenocarcinoma, Papillary carcinoma of the gallbladder, Mucinous carcinoma of the gallbladder, Adenosquamous and squamous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma, Colloid (mucinous non-cystic) carcinoma of the pancreas, Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma), Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma), Solid pseudopapillary neoplasm of the pancreas
Pancreatoduodenectomy or distal pancreatectomy with adjuvant chemotherapy as for ductal adenocarcinoma; surgery is the strongest predictor of survival in the population series.
Chemotherapy as for metastatic pancreatic ductal adenocarcinoma; no histology-specific trial exists.
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Query for this cancer: (TITLE:"Adenosquamous carcinoma of the pancreas" OR ABSTRACT:"Adenosquamous carcinoma of the pancreas" OR TITLE:"Adenosquamous carcinoma of the pancreas squamous component of at least 30 percent; about 1 percent of cases; body and tail; worse after resection" OR ABSTRACT:"Adenosquamous carcinoma of the pancreas squamous component of at least 30 percent; about 1 percent of cases; body and tail; worse after resection" OR TITLE:"Pancreatic adenosquamous carcinoma" OR ABSTRACT:"Pancreatic adenosquamous carcinoma" OR TITLE:"ASCP" OR ABSTRACT:"ASCP" OR TITLE:"Adenosquamous pancreatic cancer" OR ABSTRACT:"Adenosquamous pancreatic cancer" OR TITLE:"Mixed adenocarcinoma and squamous cell carcinoma of the pancreas" OR ABSTRACT:"Mixed adenocarcinoma and squamous cell carcinoma of the pancreas") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Adenosquamous carcinoma of the pancreas, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record.
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Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
The three main regimens share low blood counts, tiredness, sickness and sore mouth; FOLFIRINOX and NALIRIFOX add irinotecan diarrhoea and oxaliplatin's cold-triggered tingling and rare throat spasm, gemcitabine with nab-paclitaxel adds hair loss and neuropathy, and every regimen comes with the same temperature rule for ringing the 24-hour line.
See all on the product pages:FOLFIRINOX / mFOLFIRINOXGemcitabine + nab-paclitaxelNALIRIFOX (liposomal irinotecan + oxaliplatin + 5-FU/LV)·Printable cards in the navigator
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