Clinically resectable acinar cell carcinoma of the pancreas: Is there a benefit to adjuvant systemic therapy?

Background: Prior studies of adjuvant systemic therapy in pancreatic acinar cell carcinoma have been underpowered. Methods: We queried the National Cancer Data Base to identify patients presenting with resectable (clinical stage I and II) acinar cell carcinoma between 2004 and 2015. Multivariable Cox Regression was used to evaluate the association between overall survival and systemic therapy. Results: 298 patients met inclusion criteria: 38 received no treatment; 60 received systemic therapy alone; 84 received surgical resection alone; 116 underwent resection followed by adjuvant systemic therapy. On univariate analysis, resection was associated with a survival benefit compared to no treatment and systemic therapy alone (3-year overall survival: 57% vs. 26%, p < 0.001). On Cox analysis, use of adjuvant therapy was associated with a survival benefit compared to resection alone (HR 0.54, 95% CI: 0.33–0.89). Conclusions: Adjuvant therapy is associated with a significant survival benefit in patients with resectable acinar cell carcinoma.