Clinical Analysis of Acinar Cell Carcinoma of the Pancreas: A Single-Center Experience of 45 Consecutive Cases

• Published in: Cancer control 2020-10, Vol.27 (1), p.1073274820969447-1073274820969447
• Main Authors: Zhou, Wentao, Han, Xu, Fang, Yuan, Han, Siyang, Cai, Yumeng, Kuang, Tiantao, Lou, Wenhui, Wang, Dansong
• Format: Article
• Language: English
• Subjects: Aged; Carcinoma; Carcinoma, Acinar Cell - mortality; Carcinoma, Acinar Cell - secondary; Carcinoma, Acinar Cell - therapy; Cell survival; Chemoradiotherapy; Chemotherapy; Chemotherapy, Adjuvant - statistics & numerical data; Female; Follow-Up Studies; Gastrectomy; Gastrectomy - statistics & numerical data; Hepatectomy - statistics & numerical data; Humans; Kaplan-Meier Estimate; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - therapy; Male; Malignancy; Medical prognosis; Metastases; Metastasis; Middle Aged; Original Research Paper; Palliative Care - statistics & numerical data; Pancreas; Pancreas - pathology; Pancreas - surgery; Pancreatectomy - statistics & numerical data; Pancreatic cancer; Pancreatic carcinoma; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - therapy; Pancreaticoduodenectomy; Pancreaticoduodenectomy - statistics & numerical data; Patients; Prognosis; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 1073-2748; 1526-2359; 1073-2748
• DOI: 10.1177/1073274820969447

Backgrounds: Acinar cell carcinoma of the pancreas is a rare malignancy, and its features remain unclear. We aimed to analyze the clinical characteristics, treatment and prognosis of acinar cell carcinoma with our institutional case series. Methods: Patients diagnosed with acinar cell carcinoma in our hospital between 2005 and 2019 were reviewed. Investigations on clinicopathological features, treatment details and long-term survival were performed. Results: A total of 45 pathologically confirmed acinar cell carcinomas were identified. The median age at diagnosis was 58 years with a male-to-female ratio of 3.1:1. There were 24 (53.3%) localized, 5 (11.1%) locally advanced and 16 (35.6%) metastatic cases, with a pancreatic head-to-body/tail ratio of 1:1.4 for all the primary lesions. In the localized group, there were 10 pancreatoduodenectomy, 12 distal pancreatectomy, 1 total pancreatectomy, and 1 distal pancreatectomy combined with proximal gastrectomy. Among the locally advanced and metastatic cases, 13 patients received chemotherapy, 1 received concurrent radiochemotherapy, 1 underwent synchronous resection of primary tumor and liver metastasis, 1 underwent palliative operation, 1 underwent exploratory laparotomy, and 4 required no treatment. The median overall survival of this series was 18.9 months with a 5-year survival rate of 19.6%. Moreover, the resected acinar cell carcinoma patients were associated with prolonged survival compared with the unresected cases (36.6 vs. 8.5 months, P < 0.001). Conclusions: Surgical resection could improve the long-term survival of acinar cell carcinoma patients, which might also improve the prognosis of selected metastatic cases. Large-scale studies are needed to further clarify the biological behavior and clinical features, and to seek the optimal treatments.