BACKGROUND The prognosis for nonmetastatic, primary pancreatic squamous cell carcinoma (SCC) is thought to be poor compared with adenocarcinoma (AC); however, this is based on limited data. Additionally, the optimal definitive treatment strategy for nonmetastatic pancreatic SCC is unknown. METHODS We analyzed patients with nonmetastatic pancreatic cancer using the National Cancer Database for patients diagnosed from 2006 to 2014. Patients were analyzed according to histology-only AC, adenosquamous carcinoma (A-SCC), and SCC were included. The primary endpoint was overall survival (OS) from the time of diagnosis. RESULTS A total of 94 928 cases were included; 94 016 AC, 757 A-SCC, and 155 SCC. Median OS was lower for SCC (8.67 months), compared to AC (13.93 months) and A-SCC (12.71 months, P < .001). SCC was resected less often (25.5% vs 46.7% and 74.5%). On subgroup analysis of patients with pancreatic SCC, factors on multivariate analysis associated with improved survival included surgery (HR 0.19, P < .001), and chemotherapy (HR 0.22, P = .01). In 38 patients with SCC undergoing surgical resection, median OS improved (MS = 6.8 months without surgery vs 21.3 months with surgery, P < .001). CONCLUSIONS Nonmetastatic pancreatic SCC presents with more advanced disease, which is less often surgically resected or treated with any definitive local therapy. In contrast, AC and A-SCC behave more similarly and have higher surgical resection rates and improved survival. In patients with nonmetastatic SCC of the pancreas, surgical resection provides the most significant survival benefit, with systemic chemotherapy providing a less significant benefit, and localized radiation providing no statistical benefit for any subgroup.

中文翻译：

---

鳞状细胞癌组织学对非转移性胰腺癌结局的影响。

背景技术与腺癌（AC）相比，非转移性原发性胰腺鳞癌（SCC）的预后差。但是，这是基于有限的数据。此外，未知的非转移性胰腺癌的最佳确定治疗策略是未知的。方法我们使用国家癌症数据库对2006年至2014年确诊的患者进行了非转移性胰腺癌患者的分析。根据仅组织学AC，腺鳞癌（A-SCC）和SCC对患者进行分析。主要终点是从诊断开始的总体生存期（OS）。结果共纳入94 928例；94016 AC，757 A-SCC和155 SCC。与AC（13.93个月）和A-SCC（12.71个月，P <.001）相比，SCC的中位OS较低（8.67个月）。切除SCC的频率较低（25.5％对46。7％和74.5％）。在对胰腺SCC患者进行亚组分析时，与生存改善相关的多因素分析因素包括手术（HR 0.19，P <.001）和化疗（HR 0.22，P = .01）。在38例接受外科手术切除的SCC患者中，中位OS​​改善了（MS = 6.8个月（未手术）与21.3个月（手术），P <.001）。结论非转移性胰腺癌具有较晚期的疾病，较少通过外科手术切除或采用任何明确的局部疗法进行治疗。相反，AC和A-SCC的行为更相似，手术切除率更高，生存率更高。对于胰腺非转移性SCC的患者，手术切除可提供最大的生存获益，而全身化疗的获益较小。