Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: An individual participant data meta-analysis

Abstract

Undifferentiated carcinoma with osteoclast-like giant cells (UC−OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC−OGC, and to highlight its biological behavior, clinicopathologic characteristics, prognosis, and therapeutic options. A systematic review of the literature in PubMed/Medline and Scopus databases was performed (last search October 31st, 2023) for articles concerning pancreatic UC−OGC in the adult population. Fifty-seven studies met the inclusion criteria, involving 69 patients with a male-to-female ratio of 1.1:1 and a mean age of 62.96. Main symptoms included abdominal pain (33.3%), jaundice (14.5%), weight loss (8.7%), while fourteen patients (20.3%) were asymptomatic. Surgical resection was performed in 88.4% of cases. Survival rates at one, three, and five years were 58%, 44.7%, and 37.3% respectively. Sex, age, size (cut-off of 4 cm), location, and adjuvant treatment did not significantly affect patient survival. UC−OGC of the pancreas is a rare subtype of undifferentiated pancreatic carcinoma with a better prognosis than conventional pancreatic ductal adenocarcinoma or undifferentiated carcinoma without giant cells. The establishment of a dedicated patient registry is imperative to further delineate the optimal treatment for this uncommon clinical entity.

Undifferentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas: Molecular Genetic Analysis of 13 Cases

“…From a clinical point of view, UCOGC is characterized by mostly poor prognosis [ 13 , 14 ], but there are reports describing “unexpected long survivors” with a better prognosis compared to patients with PDAC [ 2 , 15 ]. A recent meta-analysis involving 69 patients revealed that UCOGC exhibits a notably superior prognosis in contrast to both PDAC and undifferentiated carcinoma (UC) lacking osteoclastic giant cells [ 16 ]. Hence, it is necessary to differentiate UCOGC from UC histologically, owing to the substantial prognostic variance [ 17 ].…”