Wisnoski 2008: 672 patients with acinar cell carcinoma of the pancreas, a population-based comparison to pancreatic adenocarcinoma
Using the US cancer registry, this study showed that people with acinar cell carcinoma live far longer than those with ordinary pancreatic cancer at every stage, and that surgery gives a large fraction of them a chance of long-term survival.
Overview
Analysis of the SEER registry from 1988 to 2003 comparing 672 patients with pancreatic acinar cell carcinoma to more than 40,000 with pancreatic ductal adenocarcinoma. Acinar cell carcinoma patients were more often men and presented with larger tumours but were more likely to undergo resection.
Survival was markedly better for acinar cell carcinoma: median survival of several years against a few months for adenocarcinoma, five-year survival many times higher, and resected patients doing best. The survival advantage held after adjustment for stage and resection.
- Acinar cell carcinoma survival was several times longer than ductal adenocarcinoma at every stage in SEER data.
- Resection was associated with the best outcomes and was performed more often than in adenocarcinoma.
Acinar cell carcinoma justifies an aggressive surgical approach, including for larger tumours and selected metastatic disease, because the natural history is far better than ductal adenocarcinoma.
- Registry data with no information on chemotherapy or molecular features.
- Histological misclassification is possible in registry coding.
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