Adenosquamous carcinoma of the pancreas has a dismal prognosis, demanding careful patient selection and management strategies.

• 1-year overall survival is 56.2%, dropping to just 9.8% at 5 years.
• Disease-free survival is equally concerning at 6.7% after 5 years.

Avoid resection of T4 tumors in high-comorbidity patients. Providing adjuvant chemotherapy is crucial but often hampered by postoperative complications.

• Key factors for poorer survival include R2 resections and lymphatic stromal invasion.