Survival and prognostic factors in patients with pancreatic squamous cell carcinoma



      Squamous cell carcinoma (SCC) of pancreas is rare entity with poorly defined prognostic factors and therapeutic outcomes. We sought to determine the overall survival (OS) and prognostic factors of patients with pancreatic SCC using National Cancer Database (NCDB) (2004–15).


      Kaplan-Meier method and log-rank test were used to perform OS analysis. Propensity-matched analysis was used to compare the OS of pancreatic SCC and adenocarcinoma.


      Of the 515 cases included in our analysis, 46% were female. Approximately half of the cohort (48%) received chemotherapy or radiation therapy or both. Twenty six percent (33/125) of stage I and II disease (localized disease), 11% (8/72) of stage III, and 2% (6/318) of stage IV disease underwent surgical resection of the primary tumor. Median OS for the entire cohort was 4 months and was significantly higher in patients who underwent surgical resection of the primary tumor (17 vs 4 months, p < 0.001). In localized disease, adjuvant chemotherapy was not associated with improved OS in early stage disease (20 vs 24 months, p = 0.60). Stage IV patients treated with chemotherapy had a better OS than those without (5 vs 2 months, p < 0.0001). Propensity matched analysis demonstrated no significant differences in median OS between pancreatic adenocarcinoma (4.8 months) and SCC (4 months, p = 0.09).


      Pancreatic SCC had a diverse OS that varied significantly according to increasing age (>70 years) and stage of the disease at presentation (p < 0.01). Surgical resection of primary tumor was associated with longer OS in stages I-II, whereas chemotherapy was associated with longer OS in stage IV disease.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Surgical Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Makarova-Rusher O.V.
        • Ulahannan S.
        • Greten T.F.
        • Duffy A.
        Pancreatic squamous cell carcinoma: a population-based study of Epidemiology, clinicopathologic characteristics and outcomes.
        Pancreas. 2016; 45: 1432-1437
        • Al-Shehri A.
        • Silverman S.
        • King K.M.
        Squamous cell carcinoma of the pancreas.
        Curr Oncol. 2008; 15: 293-297
        • Koizumi W.
        • Kitago M.
        • Shinoda M.
        • et al.
        Successful resection of pancreatic metastasis from oesophageal squamous cell carcinoma: a case report and review of the literature.
        BMC Canc. 2019; 19: 320
        • Machairas N.
        • Paspala A.
        • Schizas D.
        • et al.
        Metastatic squamous cell carcinoma to the pancreas: report of an extremely rare case.
        Mol Clin Oncol. 2019; 10: 144-146
        • Hashmi A.
        • Kozick Z.
        • Fluck M.
        • et al.
        Neoadjuvant versus adjuvant chemotherapy for resectable pancreatic adenocarcinoma: a national cancer database analysis.
        Am Surg. 2018; 84: 1439-1445
        • Paniccia A.
        • Hosokawa P.
        • Henderson W.
        • et al.
        Characteristics of 10-year survivors of pancreatic ductal adenocarcinoma.
        JAMA Surg. 2015; 150: 701-710
        • Ho D.
        • Imai K.
        • King G.
        • Stuart E.A.
        Matchit: nonparametric preprocessing for parametric causal inference.
        . 2011; 42 (2011): 28
        • Brown H.A.
        • Dotto J.
        • Robert M.
        • Salem R.R.
        Squamous cell carcinoma of the pancreas.
        J Clin Gastroenterol. 2005; 39: 915-919
        • Ben Kridis W.
        • Khanfir A.
        • Toumi N.
        • Ben Amar M.
        • Boudawara T.
        • Frikha M.
        Primary squamous cell carcinoma of the pancreas: a report of two cases and review of the literature.
        Intern Med. 2015; 54: 1357-1359
        • Lowenfels A.B.
        • Maisonneuve P.
        • Cavallini G.
        • et al.
        Pancreatitis and the risk of pancreatic cancer. International pancreatitis study group.
        N Engl J Med. 1993; 328: 1433-1437
        • Jura N.
        • Archer H.
        • Bar-Sagi D.
        Chronic pancreatitis, pancreatic adenocarcinoma and the black box in-between.
        Cell Res. 2005; 15: 72-77
        • Kenner B.J.
        • Go V.L.W.
        • Chari S.T.
        • Goldberg A.E.
        • Rothschild L.J.
        Early detection of pancreatic cancer: the role of industry in the development of biomarkers.
        Pancreas. 2017; 46: 1238-1241
        • McWilliams R.R.
        • Matsumoto M.E.
        • Burch P.A.
        • et al.
        Obesity adversely affects survival in pancreatic cancer patients.
        Cancer. 2010; 116: 5054-5062
        • Artinyan A.
        • Soriano P.A.
        • Prendergast C.
        • Low T.
        • Ellenhorn J.D.I.
        • Kim J.
        The anatomic location of pancreatic cancer is a prognostic factor for survival.
        HPB : Off J Int Hepato Pancreato Biliary Assoc. 2008; 10: 371-376
        • Abedi S.H.
        • Ahmadzadeh A.
        • Mohammad Alizadeh A.H.
        Pancreatic squamous cell carcinoma.
        Case Rep Gastroenterol. 2017; 11: 219-224
        • Itani K.M.
        • Karni A.
        • Green L.
        Squamous cell carcinoma of the pancreas.
        J Gastrointest Surg : Off J Soc Surg Aliment Tract. 1999; 3: 512-515
        • Kodavatiganti R.
        • Campbell F.
        • Hashmi A.
        • Gollins S.W.
        Primary squamous cell carcinoma of the pancreas: a case report and review of the literature.
        J Med Case Rep. 2012; 6: 295
        • Thomas D.
        • Shah N.
        • Shaaban H.
        • Maroules M.
        An interesting clinical entity of squamous cell cancer of the pancreas with liver and bone metastases: a case report and review of the literature.
        J Gastrointest Cancer. 2014; 45: 88-90
        • Murphy M.
        • Alavi K.
        • Maykel J.
        Working with existing databases.
        Clin Colon Rectal Surg. 2013; 26: 5-11
        • Bilimoria K.Y.
        • Stewart A.K.
        • Winchester D.P.
        • Ko C.Y.
        The national cancer data base: a powerful initiative to improve cancer care in the United States.
        Ann Surg Oncol. 2008; 15: 683-690