Referral and treatment patterns in pancreatic acinar cell carcinoma: A regional population-level analysis

Ranish K Patel; Michael Parappilly; Thomas L Sutton; Shay Behrens; Issac R Schwantes; Alicia J Johnson; Rodney F Pommier; Brett C Sheppard

doi:10.1016/j.amjsurg.2023.04.010

Referral and treatment patterns in pancreatic acinar cell carcinoma: A regional population-level analysis

Am J Surg. 2024 May:231:55-59. doi: 10.1016/j.amjsurg.2023.04.010. Epub 2023 Apr 18.

Authors

Ranish K Patel¹, Michael Parappilly², Thomas L Sutton¹, Shay Behrens¹, Issac R Schwantes¹, Alicia J Johnson¹, Rodney F Pommier³, Brett C Sheppard⁴

Affiliations

¹ Oregon Heath & Science University (OHSU), Department of Surgery, Division of General Surgery, Portland, OR, 97239, USA.
² Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, 2720 S. Moody Ave., Mailcode KC-CDCB, Portland, OR, 97201, USA.
³ OHSU Department of Surgery, Division of Surgical Oncology, Knight Cancer Institute, Portland, OR, 97239, USA.
⁴ Oregon Heath & Science University (OHSU), Department of Surgery, Division of General Surgery, Portland, OR, 97239, USA. Electronic address: [email protected].

PMID: 37087362
DOI: 10.1016/j.amjsurg.2023.04.010

Abstract

Background: Pancreatic acinar cell carcinoma (PACC) is a rare exocrine tumor of the pancreas. We evaluated the effect disease stage, surgical intervention, and institutional volume status plays in survival.

Methods: We queried the Oregon State Cancer Registry for patients with PACC from 1997 to 2018. Treatment and referral patterns were analyzed, and overall survival (OS) was evaluated with Kaplan-Meier and Cox-proportional hazard analysis.

Results: 43 patients were identified. Median OS was 33.1 and 7.1 months in those with locoregional and metastatic disease respectively (p = 0.008). Surgical intervention was associated with improved OS (hazard ratio 0.28, p < 0.0001). High volume center (HVC) care trended towards improving OS. While the majority of cases were diagnosed at low volume centers (74%), referral to HVCs was rare (n = 4) and limited to advanced (stage III/IV) disease.

Conclusion: Stage and surgical resection influence survival outcomes in PACC, more data is needed to delineate the impact of institutional volume status.

Keywords: Acinar cell carcinoma; Pancreas; Referral center; Surgical resection; Survival; Treatment patterns.

MeSH terms

Carcinoma, Acinar Cell* / surgery
Humans
Oregon / epidemiology
Pancreatic Neoplasms* / surgery
Referral and Consultation
Registries
Retrospective Studies