Histological variants of pancreatic ductal adenocarcinoma : a survival analysis
(2024) In Langenbeck's Archives of Surgery 409(1).- Abstract
Purpose: Pancreatic ductal adenocarcinoma (PDAC) can be classified into distinct histological subtypes based on the WHO nomenclature. The aim of this study was to compare the prognosis of conventional PDAC (cPDAC) against the other histological variants at the population level. Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to identify patients with microscopically confirmed PDAC. These patients were divided into 9 histological subgroups. Overall survival was assessed using the Kaplan-Meier method and Cox regression models stratified by tumor histology. Results: A total of 159,548 patients with PDAC were identified, of whom 95.9% had cPDAC, followed by colloid carcinoma (CC) (2.6%), adenosquamous... (More)
Purpose: Pancreatic ductal adenocarcinoma (PDAC) can be classified into distinct histological subtypes based on the WHO nomenclature. The aim of this study was to compare the prognosis of conventional PDAC (cPDAC) against the other histological variants at the population level. Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to identify patients with microscopically confirmed PDAC. These patients were divided into 9 histological subgroups. Overall survival was assessed using the Kaplan-Meier method and Cox regression models stratified by tumor histology. Results: A total of 159,548 patients with PDAC were identified, of whom 95.9% had cPDAC, followed by colloid carcinoma (CC) (2.6%), adenosquamous carcinoma (ASqC) (0.8%), signet ring cell carcinoma (SRCC) (0.5%), undifferentiated carcinoma (UC) (0.1%), undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) (0.1%), hepatoid carcinoma (HC) (0.01%), medullary carcinoma of the pancreas (MCP) (0.006%) and pancreatic undifferentiated carcinoma with rhabdoid phenotype (PUCR) (0.003%). Kaplan-Meier curves showed that PUCR had the worst prognosis (median survival: 2 months; 5-year survival: 0%), while MCP had the best prognosis (median survival: 41 months; 5-year survival: 33.3%). In a multivariable Cox model, several histological subtypes (i.e. CC, ASqC, SRCC, UCOGC) were identified as independent predictors of overall survival when compared to cPDAC. Conclusion: PDAC is a heterogenous disease and accurate identification of variant histology is important for risk stratification, as these variants may have different biological behavior.
(Less)
- author
- Bengtsson, Axel LU ; Andersson, Roland LU and Ansari, Daniel LU
- organization
- publishing date
- 2024-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Histological subtypes, Pancreatic ductal adenocarcinoma, SEER, Survival
- in
- Langenbeck's Archives of Surgery
- volume
- 409
- issue
- 1
- article number
- 312
- publisher
- Springer
- external identifiers
-
- pmid:39425752
- scopus:85206872473
- ISSN
- 1435-2443
- DOI
- 10.1007/s00423-024-03506-6
- language
- English
- LU publication?
- yes
- id
- 3497f9d5-5de4-4241-b637-87544ded342c
- date added to LUP
- 2024-12-03 14:47:25
- date last changed
- 2025-07-16 22:05:16
@article{3497f9d5-5de4-4241-b637-87544ded342c,
abstract = {{<p>Purpose: Pancreatic ductal adenocarcinoma (PDAC) can be classified into distinct histological subtypes based on the WHO nomenclature. The aim of this study was to compare the prognosis of conventional PDAC (cPDAC) against the other histological variants at the population level. Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to identify patients with microscopically confirmed PDAC. These patients were divided into 9 histological subgroups. Overall survival was assessed using the Kaplan-Meier method and Cox regression models stratified by tumor histology. Results: A total of 159,548 patients with PDAC were identified, of whom 95.9% had cPDAC, followed by colloid carcinoma (CC) (2.6%), adenosquamous carcinoma (ASqC) (0.8%), signet ring cell carcinoma (SRCC) (0.5%), undifferentiated carcinoma (UC) (0.1%), undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) (0.1%), hepatoid carcinoma (HC) (0.01%), medullary carcinoma of the pancreas (MCP) (0.006%) and pancreatic undifferentiated carcinoma with rhabdoid phenotype (PUCR) (0.003%). Kaplan-Meier curves showed that PUCR had the worst prognosis (median survival: 2 months; 5-year survival: 0%), while MCP had the best prognosis (median survival: 41 months; 5-year survival: 33.3%). In a multivariable Cox model, several histological subtypes (i.e. CC, ASqC, SRCC, UCOGC) were identified as independent predictors of overall survival when compared to cPDAC. Conclusion: PDAC is a heterogenous disease and accurate identification of variant histology is important for risk stratification, as these variants may have different biological behavior.</p>}},
author = {{Bengtsson, Axel and Andersson, Roland and Ansari, Daniel}},
issn = {{1435-2443}},
keywords = {{Histological subtypes; Pancreatic ductal adenocarcinoma; SEER; Survival}},
language = {{eng}},
number = {{1}},
publisher = {{Springer}},
series = {{Langenbeck's Archives of Surgery}},
title = {{Histological variants of pancreatic ductal adenocarcinoma : a survival analysis}},
url = {{http://dx.doi.org/10.1007/s00423-024-03506-6}},
doi = {{10.1007/s00423-024-03506-6}},
volume = {{409}},
year = {{2024}},
}