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Published on: February 2, 2024
Futility in adenosquamous pancreatic cancer
Jose Manuel Ramia1,2,3, Celia Villodre1,2,3, Dimitrios Giakoustidis4
1Department of Surgery, Hospital General Universitario Dr. Balmis, Alicante, Spain.
World Journal of Surgical Oncology
|May 20, 2026
Summary
Futility is high in pancreatic adenosquamous carcinoma (ASCP) after surgery, affecting nearly half of patients. Factors like positive margins and lack of chemotherapy increase this risk, highlighting the need for clear futility definitions.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Adenosquamous carcinoma of the pancreas (ASCP) is a rare, aggressive cancer subtype with poor outcomes.
- The concept of treatment futility in ASCP remains understudied.
- This study assesses the incidence of surgical futility in a European cohort of ASCP patients.
Purpose of the Study:
- To determine the incidence of surgical futility in pancreatic adenosquamous carcinoma (ASCP).
- To identify factors associated with futile pancreatectomy in ASCP.
- To inform clinical decision-making and care optimization for ASCP patients.
Main Methods:
- Retrospective, multicenter European study (2010-2024).
- Included consecutive patients who underwent surgery for ASCP.
- Defined futility as death within 90 days from postoperative complications or cancer-related death/recurrence within 6 months.
Main Results:
- 194 patients from 29 hospitals across 11 European countries were analyzed.
- The overall futility rate was 47.9%.
- Positive retroperitoneal margin, lymphatic invasion, and lack of adjuvant chemotherapy were significantly associated with futility.
Conclusions:
- Surgical futility is a significant concern in pancreatic adenosquamous carcinoma (ASCP), with nearly half of cases deemed futile.
- Key predictors of futility include positive surgical margins, lymphatic invasion, and عدم receiving adjuvant chemotherapy.
- Establishing an international consensus definition for futility is essential for improving patient care and shared decision-making.
