Prognosis And Role Of Adjuvant Therapy For Staging Ⅰ/Ⅱ Adenosquamous Carcinoma Of The Pancreas

ObjectiveAdenosquamous carcinoma of the pancreas(ASCP)is rare with poor prognosis.This study aimed to investigate the outcome and the pattern of adjuvant therapy and provide the insights for individualized clinical therapy for ASCP.Methods and MaterialsWe retrospectively analyzed 198 patients with one primary tumor of staging Ⅰ/Ⅱ ASCP based on the Surveillance,Epidemiology and End Results(SEER)database(2005–2016).The clinical characteristics and survival were analyzed by Kaplan-Meier(K-M)and Cox regression.The patients were categorized into six subgroups to investigate the role of adjuvant therapy with Kaplan-Meier regression.ResultsOf the 198 patients enrolled,the pathologic grades(P=0.030),primary site surgery(P﹤0.001),tumor size(P=0.040),number of examined nodes(P﹤0.001),number of positive nodes(P ﹤ 0.001),positive nodes ratio(P ﹤ 0.001),radiotherapy(P ﹤ 0.001)and chemotherapy(P ﹤ 0.001)were associated with survival of ASCP by K-M survival analysis.The patients with primary site surgery(HR=8.182,95%CI,3.599-18.603,P﹤0.001),tumor size≤40mm(HR=1.580,95%CI,1.137-2.195,P=0.006),number of positive nodes≤6(HR=2.463,95%CI,1.207-5.028,P=0.013),radiotherapy(HR=1.664,95%CI,1.111-2.492,P=0.013)and chemotherapy(HR=1.840,95%CI,1.305-2.594,P=0.001)predicted good survival by Cox regression.The results of subgroups showed that the 1 and 2-year cancer-specific survival(CSS)of surgery with chemoradiotherapy were 80.2% and48.3%,respectively.The 1 and 2-year CSS of surgery combined with chemotherapy were 53.2% and 19.9%,respectively.The 1 and 2-year CSS of surgery only were 31.5% and 15.7%,respectively.The patients with surgery combined with chemoradiotherapy predicted favorable prognosis compared to patients with surgery only(P﹤0.001)and surgery combined with chemotherapy(P=0.002).ConclusionsPrimary site surgery,tumor size≤40mm,number of positive nodes≤6,positive nodes ratio,radiotherapy and chemotherapy predicted good survival for staging Ⅰ/Ⅱ ASCP.The patients with chemoradiotherapy after surgery had favorable outcome compare with surgery with chemotherapy and surgery only.The adjuvant therapy showed benefit value in ASCP.