Pancreatic islet cell tumors in adolescents and young adults

Space: StayCurrentMD Author: Alicia M Waters, Ilan I Maizlin, Robert T Russell, Matthew Dellinger, Kenneth W Gow, Adam Goldin, Melanie Goldfarb, Jed G Nuchtern, Monica Langer, Sanjeev A Vasudevan, John J Doski, Mehul Raval, Elizabeth A. Beierle Published:

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Alicia M Waters, Ilan I Maizlin, Robert T Russell, Matthew Dellinger, Kenneth W Gow, Adam Goldin, Melanie Goldfarb, Jed G Nuchtern, Monica Langer, Sanjeev A Vasudevan, John J Doski, Mehul Raval, Elizabeth A. Beierle

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Abstract

Background

Pancreatic islet cell tumors are rare in adolescents, and most studies published to date focus on older patients. We utilized a national database to describe the histology and clinical pattern of pancreatic islet cell tumors in adolescent and young adult (AYA) patients, and to compare AYAs to older adults. We hypothesized that AYAs with pancreatic islet cell tumors would have better overall survival.

Methods

The National Cancer Data Base (NCDB, 1998–2012) was queried for AYA patients (15–39 years) with a pancreatic islet cell tumor diagnosis. Demographics, tumor characteristics, treatment modalities, and outcomes were abstracted and compared to adults (≥40 years).

Results

383 patients (56.4% female, 65% non-Hispanic Whites) were identified, with a median age of 27 (IQR 16–34) years. Islet cell carcinoma was the most common histology. Of patients with known stage of disease, 49% presented with early stage (I or II). Seventy percent of patients underwent surgical resection, including local excision 44%, Whipple procedure 37.5%, or total pancreatectomy 19%. Chemotherapy was utilized in 27% and radiotherapy in 7%. All-cause mortality was 36%. AYA patients underwent more extensive resections (p = 0.001) and had lower mortality rates (p 

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