Treatment Outcomes and Prognostic Factors in Patients With Pancreatic Adenosquamous Carcinoma: a Single-Center...

Pancreatic adenosquamous carcinomas (PASCs) are rare, and their outcomes and prognostic factors have not been fully investigated. This study described treatment outcomes and examined prognostic factors in patients with unresectable PASC who received systemic chemotherapy. In addition, we performed an exploratory comparison of gemcitabine plus nab-paclitaxel (GnP) and modified FOLFIRINOX (mFFX) as first-line therapies.

We retrospectively reviewed the data of 38 patients with unresectable PASC who underwent initial systemic chemotherapy at our institution between January 2007 and April 2023. Overall survival (OS) and progression-free survival were analyzed using the Kaplan-Meier method. Prognostic factors were examined by univariate and multivariate analyses using the Cox proportional hazards model.

The median patient age was 66 years (52.6% females). Twenty-five patients received GnP, while seven received mFFX as their initial chemotherapy. The median OS for the entire cohort was 12.5 months and the median PFS was 4.5 months. Multivariate analysis identified modified Glasgow prognostic score (mGPS) and peritoneal metastasis as independent factors associated with OS. In the exploratory comparison between the GnP and mFFX groups, no significant differences were observed in OS, PFS, or adverse events.

mGPS and peritoneal metastasis were independently associated with OS, suggesting the potential importance of nutritional and inflammatory status in patients with unresectable PASC. No significant differences in treatment outcomes were observed between GnP and mFFX regimens.