Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma

The medical records of 12 patients with pancreatic ASC undergoing surgical treatment (1993 to 2006) were retrospectively reviewed. Survival data of patients with stage IIB pancreatic adenocarcinoma and ASC undergoing surgical resection were compared.Symptoms included abdominal pain (91.7%), body weight loss (83.3%), anorexia (41.7%) and jaundice (25.0%). Tumors were located at pancreatic head in 5 (41.7%) patients, tail in 5 (41.7%), and body in 4 (33.3%). Median tumor size was 6.3 cm. Surgical resection was performed on 7 patients, bypass surgery on 3, and exploratory laparotomy with biopsy on 2. No surgical mortality was identified. Seven (58.3%) and 11 (91.7%) patients died within 6 and 12 months of operation, respectively. Median survival of 12 patients was 4.41 months. Seven patients receiving surgical resection had median survival of 6.51 months. Patients with stage IIB pancreatic ASC had shorter median survival compared to those with adenocarcinoma.Aggressive surgical management does not appear effective in treating pancreatic ASC patients. Strategies involving non-surgical treatment such as chemotherapy, radiotherapy or target agents should be tested.Adenocarcinoma accounts for the majority of pancreatic malignancies. Adenosquamous carcinoma (ASC) of the pancreas is an unusual variant of pancreatic neoplasm [1-4], and is characteristic by histological patterns of both ductal adenocarcinoma and squamous carcinoma within the same tumor. The prognosis of this rare tumor appears to be even less favorable than the common invasive ductal tumor with few patients surviving more than 1 year after surgical resection [4]. Most of studies on this disease have been small series or single case reports, and few studies have investigated the clinicopathologic features and outcome of patients with pancreatic ASC following surgical treatment [1,2,5,6]. Therefore, medical records of 12 patients with pancreatic ASC treated surgically at Chang Gung Memorial Hospital (CGMH), Taoy