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Futility in adenosquamous pancreatic cancer

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Ramia J.M.
  • Villodre C.
  • Giakoustidis D.
  • Chatzikomnitsa P.
  • Addeo P.
  • Bachellier P.
  • Nappo G.
  • Zerbi A.
  • Navez J.
  • Blanco-Fernández G.
  • Kirkegård J.
  • Busquets J.
  • Björnsson B.
  • Sánchez-Cabús S.
  • Pando E.
  • Staubli S.M.
  • Pandanaboyana S.
  • Aparicio-López D.
  • Spiers H.V.M.
  • Melgar P.
  • Rhaiem R.
  • Amaral M.J.
  • Vallejo-Bernad C.
  • Andersson B.
  • Burdío F.
  • Tzimas G.
  • Mora-Oliver I.
  • Rousek M.
  • Domingo-del-Pozo C.
  • Mahamid A.
  • Lytras D.
  • Lolis E.D.
  • Sorribas M.
  • López P.A.
  • Elghonemy H.
  • Chikkala B.
  • Lim W.
  • Balakrishnan A.
  • Villamonte Román M.
  • Hörndler-Algárate C.
  • Serradilla-Martín M.

Grupos

Abstract

Background: Adenosquamous carcinoma of the pancreas (ASCP) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. Futility in ASCP has been inadequately studied. The aim is to assess the incidence of futility in ASCP cases within a European cohort. Methods: Retrospective, multicenter European study including all consecutive patients who underwent surgery for ASCP between 2010 and 2024. Inclusion criteria: patients operated for ASCP during the study period. Exclusion criteria: patients without a confirmed pathological diagnosis of ASCP, those who did not undergo surgery, or had extra-pancreatic disease. A pancreatectomy was considered futile if a patient died from postoperative complications within 90 days, or if cancer-related mortality or recurrence occurred within 6 months of the operation. Results: 194 patients from 29 hospitals in 11 European countries were studied. Surgeries included 125 pancreaticoduodenectomies, 59 left pancreatectomies, and 10 total pancreatectomies. Major complications were observed in 25.3% of patients. Postoperative mortality was 5.7%. The rate of futility was 47.9%. Eleven patients (11,8%) died from postoperative complications, 69 patients (74,2%) had recurrence, and 13 patients (14%) died within 6 months due to cancer. In the multivariate analysis, a positive retroperitoneal margin, lymphatic invasion, and not receiving chemotherapy were associated with futility. Conclusions: The futility observed in ASCP is notably high and related to a positive retroperitoneal margin, lymphatic invasion, and not receiving adjuvant chemotherapy. Defining futile patients with an international consensus definition is crucial and has significant implications for shared decision-making and care optimization. © The Author(s) 2026.

Datos de la publicación

ISSN/ISSNe:
1477-7819, 1477-7819

World Journal of Surgical Oncology  BMC

Tipo:
Article
Páginas:
-
PubMed:
42157261
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,716 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Aged; Carcinoma, Adenosquamous; Europe; Female; Follow-Up Studies; Humans; Male; Medical Futility; Middle Aged; Neoplasm Recurrence, Local; Pancreatectomy; Pancreatic Neoplasms; Pancreaticoduodenectomy; Postoperative Complications; Prognosis; Retrospective Studies; Survival Rate; alanine aminotransferase; aspartate aminotransferase; bilirubin; hemoglobin; abdominal abscess; adenosquamous pancreatic cancer; adjuvant chemotherapy; aged; Article; bile leakage; bleeding; body mass; cancer related mortality; carcinomatosis; cell invasion; cohort analysis; decision making; endoscopy; female; good clinical practice; human; liver metastasis; lymphatic invasion; major clinical study; male; minimally invasive procedure; minimally invasive surgery; mortality; observational study; pancreas cancer; pancreas fistula; pancreatectomy; pancreaticoduodenectomy; pneumonia; post pancreatectomy hemorrhage; postoperative complication; postoperative hemorrhage; retrospective study; stomach paresis; survival

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