Clinical outcomes for anaplastic pancreatic cancer: A population-based study

Clancy J. Clark, Rondell Graham, Janani S. Arun, W. Scott Harmsen, Kaye M. Reid-Lombardo

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Anaplastic pancreatic cancer (APC) is a rare subtype of pancreatic ductal adenocarcinoma (PDA) that can carry a worse overall survival (OS) when compared with other variants. However, the presence of osteoclast-like giant cells (OCGCs) in APC specimens can predict improved OS. The aim of this study was to evaluate the OS of patients with APC (with and without OCGCs) compared with patients with other subtypes of PDA using a population-based registry. Study Design: We identified all patients in the Surveillance, Epidemiology and End Results (SEER) database with pathologically confirmed APC and PDA diagnosed between 1988 and 2008. Overall survival was evaluated using Kaplan-Meier and Cox proportional hazard regression. Results: The study cohort included 5,859 (94.3%) patients with PDA and 353 (5.7%) with APC. Overall survival for all patients with APC was significantly worse than for patients with PDA (hazard ratio [HR] = 1.9; 95% CI, 1.7-2.1; p < 0.001); however, in the subgroup of resected patients, APC (n = 81) had similar OS to PDA (n = 3,517) (HR = 0.9; 95% CI, 0.7-1.2; p = 0.37). Patients with APC tumors with OCGCs (n = 11) demonstrated improved OS when compared with all other APC variants without OCGCs (n = 342) (HR = 0.3; 95% CI, 0.1-0.7; p = 0.004), but this survival difference was not observed in the subgroup of resected patients (HR = 0.5; 95% CI, 0.2-1.4; p = 0.18). Conclusions: Anaplastic pancreatic cancer is a rare malignancy with poor OS. The diagnosis of APC with OCGCs is predictive of improved OS compared with other patients with APC. This survival benefit, however, is not observed in patients with resected disease.

Original languageEnglish (US)
Pages (from-to)627-634
Number of pages8
JournalJournal of the American College of Surgeons
Volume215
Issue number5
DOIs
StatePublished - Nov 1 2012

Fingerprint

Pancreatic Neoplasms
Survival
Population
Osteoclasts
Giant Cells
Adenocarcinoma
Registries
Neoplasms
Epidemiology
Cohort Studies
Databases

Keywords

  • anaplastic pancreatic cancer
  • APC
  • hazard ratio
  • HR
  • NOS
  • not otherwise specified
  • OCGC
  • OS
  • osteoclast-like giant cells
  • overall survival
  • pancreatic ductal adenocarcinoma
  • PDA
  • SEER
  • Surveillance, Epidemiology and End Results

ASJC Scopus subject areas

  • Surgery

Cite this

Clinical outcomes for anaplastic pancreatic cancer : A population-based study. / Clark, Clancy J.; Graham, Rondell; Arun, Janani S.; Harmsen, W. Scott; Reid-Lombardo, Kaye M.

In: Journal of the American College of Surgeons, Vol. 215, No. 5, 01.11.2012, p. 627-634.

Research output: Contribution to journalArticle

Clark, Clancy J. ; Graham, Rondell ; Arun, Janani S. ; Harmsen, W. Scott ; Reid-Lombardo, Kaye M. / Clinical outcomes for anaplastic pancreatic cancer : A population-based study. In: Journal of the American College of Surgeons. 2012 ; Vol. 215, No. 5. pp. 627-634.
@article{73e859e87f8d4a6a930b70949b05fb72,
title = "Clinical outcomes for anaplastic pancreatic cancer: A population-based study",
abstract = "Background: Anaplastic pancreatic cancer (APC) is a rare subtype of pancreatic ductal adenocarcinoma (PDA) that can carry a worse overall survival (OS) when compared with other variants. However, the presence of osteoclast-like giant cells (OCGCs) in APC specimens can predict improved OS. The aim of this study was to evaluate the OS of patients with APC (with and without OCGCs) compared with patients with other subtypes of PDA using a population-based registry. Study Design: We identified all patients in the Surveillance, Epidemiology and End Results (SEER) database with pathologically confirmed APC and PDA diagnosed between 1988 and 2008. Overall survival was evaluated using Kaplan-Meier and Cox proportional hazard regression. Results: The study cohort included 5,859 (94.3{\%}) patients with PDA and 353 (5.7{\%}) with APC. Overall survival for all patients with APC was significantly worse than for patients with PDA (hazard ratio [HR] = 1.9; 95{\%} CI, 1.7-2.1; p < 0.001); however, in the subgroup of resected patients, APC (n = 81) had similar OS to PDA (n = 3,517) (HR = 0.9; 95{\%} CI, 0.7-1.2; p = 0.37). Patients with APC tumors with OCGCs (n = 11) demonstrated improved OS when compared with all other APC variants without OCGCs (n = 342) (HR = 0.3; 95{\%} CI, 0.1-0.7; p = 0.004), but this survival difference was not observed in the subgroup of resected patients (HR = 0.5; 95{\%} CI, 0.2-1.4; p = 0.18). Conclusions: Anaplastic pancreatic cancer is a rare malignancy with poor OS. The diagnosis of APC with OCGCs is predictive of improved OS compared with other patients with APC. This survival benefit, however, is not observed in patients with resected disease.",
keywords = "anaplastic pancreatic cancer, APC, hazard ratio, HR, NOS, not otherwise specified, OCGC, OS, osteoclast-like giant cells, overall survival, pancreatic ductal adenocarcinoma, PDA, SEER, Surveillance, Epidemiology and End Results",
author = "Clark, {Clancy J.} and Rondell Graham and Arun, {Janani S.} and Harmsen, {W. Scott} and Reid-Lombardo, {Kaye M.}",
year = "2012",
month = "11",
day = "1",
doi = "10.1016/j.jamcollsurg.2012.06.418",
language = "English (US)",
volume = "215",
pages = "627--634",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Clinical outcomes for anaplastic pancreatic cancer

T2 - A population-based study

AU - Clark, Clancy J.

AU - Graham, Rondell

AU - Arun, Janani S.

AU - Harmsen, W. Scott

AU - Reid-Lombardo, Kaye M.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - Background: Anaplastic pancreatic cancer (APC) is a rare subtype of pancreatic ductal adenocarcinoma (PDA) that can carry a worse overall survival (OS) when compared with other variants. However, the presence of osteoclast-like giant cells (OCGCs) in APC specimens can predict improved OS. The aim of this study was to evaluate the OS of patients with APC (with and without OCGCs) compared with patients with other subtypes of PDA using a population-based registry. Study Design: We identified all patients in the Surveillance, Epidemiology and End Results (SEER) database with pathologically confirmed APC and PDA diagnosed between 1988 and 2008. Overall survival was evaluated using Kaplan-Meier and Cox proportional hazard regression. Results: The study cohort included 5,859 (94.3%) patients with PDA and 353 (5.7%) with APC. Overall survival for all patients with APC was significantly worse than for patients with PDA (hazard ratio [HR] = 1.9; 95% CI, 1.7-2.1; p < 0.001); however, in the subgroup of resected patients, APC (n = 81) had similar OS to PDA (n = 3,517) (HR = 0.9; 95% CI, 0.7-1.2; p = 0.37). Patients with APC tumors with OCGCs (n = 11) demonstrated improved OS when compared with all other APC variants without OCGCs (n = 342) (HR = 0.3; 95% CI, 0.1-0.7; p = 0.004), but this survival difference was not observed in the subgroup of resected patients (HR = 0.5; 95% CI, 0.2-1.4; p = 0.18). Conclusions: Anaplastic pancreatic cancer is a rare malignancy with poor OS. The diagnosis of APC with OCGCs is predictive of improved OS compared with other patients with APC. This survival benefit, however, is not observed in patients with resected disease.

AB - Background: Anaplastic pancreatic cancer (APC) is a rare subtype of pancreatic ductal adenocarcinoma (PDA) that can carry a worse overall survival (OS) when compared with other variants. However, the presence of osteoclast-like giant cells (OCGCs) in APC specimens can predict improved OS. The aim of this study was to evaluate the OS of patients with APC (with and without OCGCs) compared with patients with other subtypes of PDA using a population-based registry. Study Design: We identified all patients in the Surveillance, Epidemiology and End Results (SEER) database with pathologically confirmed APC and PDA diagnosed between 1988 and 2008. Overall survival was evaluated using Kaplan-Meier and Cox proportional hazard regression. Results: The study cohort included 5,859 (94.3%) patients with PDA and 353 (5.7%) with APC. Overall survival for all patients with APC was significantly worse than for patients with PDA (hazard ratio [HR] = 1.9; 95% CI, 1.7-2.1; p < 0.001); however, in the subgroup of resected patients, APC (n = 81) had similar OS to PDA (n = 3,517) (HR = 0.9; 95% CI, 0.7-1.2; p = 0.37). Patients with APC tumors with OCGCs (n = 11) demonstrated improved OS when compared with all other APC variants without OCGCs (n = 342) (HR = 0.3; 95% CI, 0.1-0.7; p = 0.004), but this survival difference was not observed in the subgroup of resected patients (HR = 0.5; 95% CI, 0.2-1.4; p = 0.18). Conclusions: Anaplastic pancreatic cancer is a rare malignancy with poor OS. The diagnosis of APC with OCGCs is predictive of improved OS compared with other patients with APC. This survival benefit, however, is not observed in patients with resected disease.

KW - anaplastic pancreatic cancer

KW - APC

KW - hazard ratio

KW - HR

KW - NOS

KW - not otherwise specified

KW - OCGC

KW - OS

KW - osteoclast-like giant cells

KW - overall survival

KW - pancreatic ductal adenocarcinoma

KW - PDA

KW - SEER

KW - Surveillance, Epidemiology and End Results

UR - http://www.scopus.com/inward/record.url?scp=84867825510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867825510&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2012.06.418

DO - 10.1016/j.jamcollsurg.2012.06.418

M3 - Article

C2 - 23084492

AN - SCOPUS:84867825510

VL - 215

SP - 627

EP - 634

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 5

ER -