Treatment characteristics and outcomes of pure Acinar cell carcinoma of the pancreas - A multicentric European study on radically resected patients
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Treatment characteristics and outcomes of pure Acinar cell carcinoma of the pancreas - A multicentric European study on radically resected patients. / Bellotti, Ruben; Paiella, Salvatore; Primavesi, Florian; Jäger, Carsten; Demir, Ihsan E; Casciani, Fabio; Kornprat, Peter; Wagner, Doris; Rösch, Christiane S; Butturini, Giovanni; Giardino, Alessandro; Goretzki, Peter; Mogl, Martina; Fahlbusch, Tim; Kaiser, Jörg; Strobel, Oliver; Nießen, Anna; Luu, Andreas M; Salvia, Roberto; Maglione, Manuel.
in: HPB, Jahrgang 25, Nr. 11, 11.2023, S. 1411-1419.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Treatment characteristics and outcomes of pure Acinar cell carcinoma of the pancreas - A multicentric European study on radically resected patients
AU - Bellotti, Ruben
AU - Paiella, Salvatore
AU - Primavesi, Florian
AU - Jäger, Carsten
AU - Demir, Ihsan E
AU - Casciani, Fabio
AU - Kornprat, Peter
AU - Wagner, Doris
AU - Rösch, Christiane S
AU - Butturini, Giovanni
AU - Giardino, Alessandro
AU - Goretzki, Peter
AU - Mogl, Martina
AU - Fahlbusch, Tim
AU - Kaiser, Jörg
AU - Strobel, Oliver
AU - Nießen, Anna
AU - Luu, Andreas M
AU - Salvia, Roberto
AU - Maglione, Manuel
N1 - Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2023/11
Y1 - 2023/11
N2 - BACKGROUND: Acinar cell carcinomas (ACC) belong to the exocrine pancreatic malignancies. Due to their rarity, there is no consensus regarding treatment strategies for resectable ACC.METHODS: This is a retrospective multicentric study of radically resected pure pancreatic ACC. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Further endpoints were oncologic outcomes related to tumor stage and therapeutic protocols.RESULTS: 59 patients (44 men) with a median age of 64 years were included. The median tumor size was 45.0 mm. 61.0% were pT3 (n = 36), nodal positivity rate was 37.3% (n = 22), and synchronous distant metastases were present in 10.1% of the patients (n = 6). 5-Years OS was 60.9% and median DFS 30 months. 24 out of 31 recurred systemically (n = 18 only systemic, n = 6 local and systemic). Regarding TNM-staging, only the N2-stage negatively influenced OS and DFS (p = 0.004, p = 0.001). Adjuvant treatment protocols (performed in 62.7%) did neither improve OS (p = 0.542) nor DFS (p = 0.159). In 9 cases, radical resection was achieved following neoadjuvant therapy.DISCUSSION: Radical surgery is currently the mainstay for resectable ACC, even for limited metastatic disease. Novel (neo)adjuvant treatment strategies are needed, since current systemic therapies do not result in a clear survival benefit in the perioperative setting.
AB - BACKGROUND: Acinar cell carcinomas (ACC) belong to the exocrine pancreatic malignancies. Due to their rarity, there is no consensus regarding treatment strategies for resectable ACC.METHODS: This is a retrospective multicentric study of radically resected pure pancreatic ACC. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Further endpoints were oncologic outcomes related to tumor stage and therapeutic protocols.RESULTS: 59 patients (44 men) with a median age of 64 years were included. The median tumor size was 45.0 mm. 61.0% were pT3 (n = 36), nodal positivity rate was 37.3% (n = 22), and synchronous distant metastases were present in 10.1% of the patients (n = 6). 5-Years OS was 60.9% and median DFS 30 months. 24 out of 31 recurred systemically (n = 18 only systemic, n = 6 local and systemic). Regarding TNM-staging, only the N2-stage negatively influenced OS and DFS (p = 0.004, p = 0.001). Adjuvant treatment protocols (performed in 62.7%) did neither improve OS (p = 0.542) nor DFS (p = 0.159). In 9 cases, radical resection was achieved following neoadjuvant therapy.DISCUSSION: Radical surgery is currently the mainstay for resectable ACC, even for limited metastatic disease. Novel (neo)adjuvant treatment strategies are needed, since current systemic therapies do not result in a clear survival benefit in the perioperative setting.
U2 - 10.1016/j.hpb.2023.07.897
DO - 10.1016/j.hpb.2023.07.897
M3 - SCORING: Journal article
C2 - 37563033
VL - 25
SP - 1411
EP - 1419
JO - HPB
JF - HPB
SN - 1365-182X
IS - 11
ER -