Pancreatic islet cell tumors in adolescents and young adults

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 V Raval, Elizabeth A. Beierle*

*Corresponding author for this work

Research output: Contribution to journalArticle

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 < 0.001), with no differences in tumor stage or use of adjuvant therapies, when compared to adults. Conclusions: AYA patients with pancreatic islet cell tumors had comparable utilization of adjuvant therapies but underwent more extensive resections and demonstrated a higher overall survival rate than adult counterparts. Further investigation into approaches to earlier diagnosis and tailoring of multimodality therapy of these neoplasms in the AYA population is needed. Levels of evidence: Prognostic Study, Level II — retrospective study.

Original languageEnglish (US)
JournalJournal of pediatric surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Young Adult
Neoplasms
Histology
Islet Cell Carcinoma
Databases
Pancreatectomy
Mortality
Pancreatic islet cell tumors
Early Diagnosis
Radiotherapy
Therapeutics
Survival Rate
Retrospective Studies
Demography
Drug Therapy
Survival
Population

Keywords

  • Adolescent
  • Islet cell neoplasm
  • Pancreas
  • Tumor

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Waters, A. M., Maizlin, I. I., Russell, R. T., Dellinger, M., Gow, K. W., Goldin, A., ... Beierle, E. A. (2019). Pancreatic islet cell tumors in adolescents and young adults. Journal of pediatric surgery. https://doi.org/10.1016/j.jpedsurg.2019.01.060
Waters, Alicia M. ; Maizlin, Ilan I. ; Russell, Robert T. ; Dellinger, Matthew ; Gow, Kenneth W. ; Goldin, Adam ; Goldfarb, Melanie ; Nuchtern, Jed G. ; Langer, Monica ; Vasudevan, Sanjeev A. ; Doski, John J. ; Raval, Mehul V ; Beierle, Elizabeth A. / Pancreatic islet cell tumors in adolescents and young adults. In: Journal of pediatric surgery. 2019.
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title = "Pancreatic islet cell tumors in adolescents and young adults",
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 < 0.001), with no differences in tumor stage or use of adjuvant therapies, when compared to adults. Conclusions: AYA patients with pancreatic islet cell tumors had comparable utilization of adjuvant therapies but underwent more extensive resections and demonstrated a higher overall survival rate than adult counterparts. Further investigation into approaches to earlier diagnosis and tailoring of multimodality therapy of these neoplasms in the AYA population is needed. Levels of evidence: Prognostic Study, Level II — retrospective study.",
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author = "Waters, {Alicia M.} and Maizlin, {Ilan I.} and Russell, {Robert T.} and Matthew Dellinger and Gow, {Kenneth W.} and Adam Goldin and Melanie Goldfarb and Nuchtern, {Jed G.} and Monica Langer and Vasudevan, {Sanjeev A.} and Doski, {John J.} and Raval, {Mehul V} and Beierle, {Elizabeth A.}",
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Waters, AM, Maizlin, II, Russell, RT, Dellinger, M, Gow, KW, Goldin, A, Goldfarb, M, Nuchtern, JG, Langer, M, Vasudevan, SA, Doski, JJ, Raval, MV & Beierle, EA 2019, 'Pancreatic islet cell tumors in adolescents and young adults', Journal of pediatric surgery. https://doi.org/10.1016/j.jpedsurg.2019.01.060

Pancreatic islet cell tumors in adolescents and young adults. / Waters, Alicia M.; Maizlin, Ilan I.; Russell, Robert T.; Dellinger, Matthew; Gow, Kenneth W.; Goldin, Adam; Goldfarb, Melanie; Nuchtern, Jed G.; Langer, Monica; Vasudevan, Sanjeev A.; Doski, John J.; Raval, Mehul V; Beierle, Elizabeth A.

In: Journal of pediatric surgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pancreatic islet cell tumors in adolescents and young adults

AU - Waters, Alicia M.

AU - Maizlin, Ilan I.

AU - Russell, Robert T.

AU - Dellinger, Matthew

AU - Gow, Kenneth W.

AU - Goldin, Adam

AU - Goldfarb, Melanie

AU - Nuchtern, Jed G.

AU - Langer, Monica

AU - Vasudevan, Sanjeev A.

AU - Doski, John J.

AU - Raval, Mehul V

AU - Beierle, Elizabeth A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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 < 0.001), with no differences in tumor stage or use of adjuvant therapies, when compared to adults. Conclusions: AYA patients with pancreatic islet cell tumors had comparable utilization of adjuvant therapies but underwent more extensive resections and demonstrated a higher overall survival rate than adult counterparts. Further investigation into approaches to earlier diagnosis and tailoring of multimodality therapy of these neoplasms in the AYA population is needed. Levels of evidence: Prognostic Study, Level II — retrospective study.

AB - 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 < 0.001), with no differences in tumor stage or use of adjuvant therapies, when compared to adults. Conclusions: AYA patients with pancreatic islet cell tumors had comparable utilization of adjuvant therapies but underwent more extensive resections and demonstrated a higher overall survival rate than adult counterparts. Further investigation into approaches to earlier diagnosis and tailoring of multimodality therapy of these neoplasms in the AYA population is needed. Levels of evidence: Prognostic Study, Level II — retrospective study.

KW - Adolescent

KW - Islet cell neoplasm

KW - Pancreas

KW - Tumor

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