C. V. De Carvalho Fischer1, H. N. Overton1, C. L. Wolfgang1, C. Meyer2, F. M. Johnston1, N. Ahuja1 1Johns Hopkins University School Of Medicine,Department Of Surgery,Baltimore, MD, USA 2Johns Hopkins University School Of Medicine,Medical Oncology,Baltimore, MD, USA
Introduction:
Primary pancreatic sarcoma is a rare intra-abdominal neoplasm with relatively unknown survival rates due to limited reports in the literature. We present the only known case series of pancreatic sarcoma from a single-institution 15 year experience and aim to compare to previously reported retroperitoneal sarcoma overall survival (OS) and recurrence free interval (RFI) at the same institution.
Methods:
Retrospective analysis of all primary pancreatic sarcomas at Johns Hopkins Hospital from 1990 to 2015. Overall survival and recurrence free interval after surgical resection was determined using the Kaplan-Meier method on GraphPad Prism 6.
Results:
Pancreatic sarcoma patients were an average age of 57.8 years (+/- 13.62) at diagnosis. Liposarcomas were the most common histological tumor type, affecting six of eighteen patients with primary sarcomas of the pancreas. Other histology included leiomyosarcoma or GIST phenotype, epitheloid angiosarcomas and fibrosarcomas of the pancreas, and malignant spindle cell tumor. On average, the largest diameter of the tumor was 11.92cm (+/- 8.32). The tumor was classified as high grade in eight cases whereas only four cases were described as low or intermediate grade malignancies. The tumor grade remained undefined in six cases. Only two out of eighteen sarcomas were deemed unresectable. The remaining patients had surgical interventions, out of which 55.56% (10/18) underwent a Whipple procedure, and 33.33% (6/18) underwent a distal pancreatectomy. Pathology reports defined eight cases as having achieved a R0 resection, four of eighteen with R1 resections and two of eighteen with R2 resections. The median overall survival of this collective was 32 months whereas the median recurrence free interval following surgical resection was 14 months. In comparison, recent analysis of retroperitoneal sarcoma outcomes treated at the Johns Hopkins Hospital within the same time period demonstrated overall survival of 48.7 months and recurrence free survival of 20 months. Given the small smaple size in the case series of pancreatic sarcoma, analysis of variables important in survival, such as grade and resection status, could not be performed.
Conclusion:
Pancreatic sarcoma demonstrated decreased overall survival and recurrence free survival after surgical resection when compared to retroperitoneal sarcoma treated at the same institution. Though a rare tumor type, the data presented warrants further research on pancreatic sarcoma.
