Mucinous cystadenocarcinoma of the pancreas - outcome following different modes of treatment.

Background: Mucinous cystadenocarcinomas (MCAC) of the pancreas are rare tumors. When localized to the pancreas alone, surgical resection is mostly associated with a favorable prognosis. The potential value of palliative treatment with chemotherapy for irresectable disease is scarcely described though. The aim of this study was to describe a single-center series of patients with MCAC of the pancreas focusing on the outcome following different treatment strategies.

Methods: 15 patients, 10 females and 5 males, with histologically or cytologically verified MCAC, were divided into three groups: surgical resection (n=7), chemotherapy (n=5) and no treatment (n=3).

Results: There was no obvious difference in gender distribution between the subgroups. A tendency towards higher age was seen in the group without treatment, as was a larger tumor size as compared to the chemotherapy group. Patients were administered chemotherapy and the group without treatment seemed to present with the same prevalence of metastatic disease (3/5 and 2/3, respectively). All patients in the group without treatment died after in median 1 month following pathological diagnosis. One patient in the chemotherapy group was alive at 9-month follow up, and the others survived a median of 11 months. In the surgically treated group, 4/7 were alive at follow-up of a median of 154 months. Of the three deceased patients who had survived 44, 53 and 151 months, respectively, two had microscopically non-radical resection.

Conclusions: MCAC of the pancreas is, when locally confined and without metastases, associated with fairly good prognosis after surgical resection. In inoperable patients and for metastatic disease, outcome is poor.