Korean J Hepatobiliary Pancreat Surg.  2009 Mar;13(1):54-59.

The Clinical Characteristics of Acinar Cell Carcinoma in the Pancreas

Affiliations
  • 1Department of surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. kskim88@yuhs.ac.kr
  • 2Department of Surgery, Guro Hospital, Korea University, College of Medicine, Seoul, Korea.
  • 3Department of surgery, Kangnam severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Acinar cell carcinoma (ACC) is a very rare type of pancreatic cancer that makes up less than 1% of all pancreatic cancers. The prognosis of ACC is very poor and the mean survival interval is only 18-19 months. The only effective treatment is currently early radical resection.
MATERIALS AND METHODS
To determine ACC`s clinical characteristics and the treatment efficacy, we conducted a retrospective chart review to study the clinical characteristics, laboratory findings, pathology and treatment responses of 10 ACC patients among 3042 pancreatic cancer patients who were diagnosed in Severance Hospital and Kangnam Severance Hospital of Yonsei University, College of Medicine from 1988.01.01 to 2008.12.31.
RESULTS
The 10 ACC patients were 6 males and 4 females. The mean age of the 10 ACC patients was 53.2 years. The most of the patients (7/10) complained the pain on the epigastric area and there was no jaundice in 8 patients (80%). Unfortunately, regional or distant metastases were founded in 8 patients (80%) at the time of the first diagnosis. The initial mean CA19-9 level was increased to 73.5 U/ml (range: 0.1~350.0 U/ml). Six of 10 patients underwent radical surgery and 4 of 10, including 1 with open and closure, were treated with conservative treatment. The median survival interval was 22.4 months with operative treatment and 1.5 months with conservative treatment. The median overall survival interval was 19.4 months. The median disease free survival was 17 months. The liver was the most common recurrent site (3 cases).
CONCLUSIONS
An early radical resection is currently the best and only treatment for ACC, but in rare cases, post-operative adjuvant chemotherapy shows hopeful results and so this requires more study.

Keyword

Pancreatic cancer; Acinar cell carcinoma; CA19-9; radical resection; Adjuvant chemotherapy

MeSH Terms

Acinar Cells
Carcinoma, Acinar Cell
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Humans
Jaundice
Liver
Male
Neoplasm Metastasis
Pancreas
Pancreatic Neoplasms
Prognosis
Retrospective Studies
Treatment Outcome
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