Faculty Collaboration Database

Nonfunctioning islet cell carcinoma of the pancreas. Surgery 1993 Dec;114(6):1175-81; discussion 1181-2

Date

12/01/1993

Pubmed ID

7903005

Scopus ID

2-s2.0-0027133595 (requires institutional sign-in at Scopus site)   104 Citations

Abstract

BACKGROUND: Nonfunctioning islet cell carcinoma of the pancreas has a variable and often indolent natural history, which has resulted in a wide range of treatment recommendations. To more clearly define the natural history and appropriate treatment of this disease, we reviewed our institutional experience over the last 39 years.

METHODS: The records of all patients confirmed to have a nonfunctioning islet cell carcinoma of the pancreas were retrospectively reviewed. Kaplan-Meier life tables were constructed and log-rank comparisons were performed.

RESULTS: The 73 patients studied had an overall 5-year actuarial survival rate of 50%. Patients with localized disease at presentation (n = 39) had a significantly higher survival rate (p = 0.03) compared with patients with metastatic disease (n = 34). The 19 patients who underwent a potentially curative resection of the primary tumor had a significantly higher survival rate (p = 0.03) compared with the 20 patients with locally advanced, unresectable, nonmetastatic disease. Nine of these 20 patients died of complications of the primary tumor. In contrast, only 2 of 22 cancer-related deaths in the 34 patients with metastatic disease at diagnosis were due to the primary tumor.

CONCLUSIONS: (1) Surgical resection should be performed in patients with resectable nonmetastatic disease. (2) Resection of the primary tumor in the presence of metastatic disease is rarely indicated. (3) Innovative treatment strategies are needed for patients with locally advanced, unresectable, nonmetastatic tumors of the pancreatic head.

Author List

Evans DB, Skibber JM, Lee JE, Cleary KR, Ajani JA, Gagel RF, Sellin RV, Fenoglio CJ, Merrell RC, Hickey RC

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Carcinoma, Islet Cell
Female
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local
Pancreatectomy
Pancreatic Neoplasms
Pancreaticoduodenectomy
Postoperative Complications
Retrospective Studies
Survival Analysis