Survival impact of malignant pancreatic neuroendocrine and islet cell neoplasm phenotypes

Christina L. Roland, Aihua Bian, John C. Mansour, Adam C. Yopp, Glen C. Balch, Rohit Sharma, Xian Jin Xie, Roderich E. Schwarz

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background The low incidence of malignant "functional" (F) or "nonfunctional" (NF) neuroendocrine islet cell tumors (ICTs) of the pancreas represents a challenge to precise post-therapeutic survival prediction. This study examined the survival impact of malignant pancreatic ICT morphologic subtypes. Methods A pancreatic ICT data set was created from a US-based population database from 1980-2004. Prognostic factors with survival impact and relationships between surgical therapy and overall survival (OS) were analyzed. Results There were 2,350 individuals with malignant ICTs. Histologic subtypes included carcinoid tumors, islet cell carcinomas, neuroendocrine carcinomas, and malignant gastrinomas, insulinomas, glucagonomas, or VIPomas. There was no difference in resection rates between FICTs and NFICTs (23% vs. 20%, P = ns). Median OS was 30 months, with group differences ranging from NE carcinomas (21) to VIPomas (96; P < 0.0001). Median OS of resected versus unresected FICTs was 172 versus 37 months, while that of NFICTs was 113 versus 18 months (P < 0.0001). Compared to neuroendocrine carcinomas, hazard ratios were: VIPomas 0.48, gastrinomas 0.65, carcinoid tumors 0.76, insulinomas 0.84, glucagonomas 0.93, and islet cell carcinomas 1.0. Conclusions When controlled for other established prognostic parameters, histopathologic subtype assignment of pancreatic ICTs affects survival prediction. Resection is associated with superior survival for all tumor types. J. Surg. Oncol. 2012; 105:595-600.

Original languageEnglish (US)
Pages (from-to)595-600
Number of pages6
JournalJournal of Surgical Oncology
Volume105
Issue number6
DOIs
StatePublished - May 2012

Fingerprint

Islet Cell Carcinoma
Neuroendocrine Cells
Vipoma
Islets of Langerhans
Glucagonoma
Gastrinoma
Phenotype
Neuroendocrine Carcinoma
Insulinoma
Carcinoid Tumor
Neoplasms
Islet Cell Adenoma
Neuroendocrine Tumors
Pancreas
Databases
Carcinoma
Incidence
Therapeutics
Population
Pancreatic islet cell tumors

Keywords

  • pancreatic neuroendocrine tumor
  • SEER population data
  • survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Survival impact of malignant pancreatic neuroendocrine and islet cell neoplasm phenotypes. / Roland, Christina L.; Bian, Aihua; Mansour, John C.; Yopp, Adam C.; Balch, Glen C.; Sharma, Rohit; Xie, Xian Jin; Schwarz, Roderich E.

In: Journal of Surgical Oncology, Vol. 105, No. 6, 05.2012, p. 595-600.

Research output: Contribution to journalArticle

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N2 - Background The low incidence of malignant "functional" (F) or "nonfunctional" (NF) neuroendocrine islet cell tumors (ICTs) of the pancreas represents a challenge to precise post-therapeutic survival prediction. This study examined the survival impact of malignant pancreatic ICT morphologic subtypes. Methods A pancreatic ICT data set was created from a US-based population database from 1980-2004. Prognostic factors with survival impact and relationships between surgical therapy and overall survival (OS) were analyzed. Results There were 2,350 individuals with malignant ICTs. Histologic subtypes included carcinoid tumors, islet cell carcinomas, neuroendocrine carcinomas, and malignant gastrinomas, insulinomas, glucagonomas, or VIPomas. There was no difference in resection rates between FICTs and NFICTs (23% vs. 20%, P = ns). Median OS was 30 months, with group differences ranging from NE carcinomas (21) to VIPomas (96; P < 0.0001). Median OS of resected versus unresected FICTs was 172 versus 37 months, while that of NFICTs was 113 versus 18 months (P < 0.0001). Compared to neuroendocrine carcinomas, hazard ratios were: VIPomas 0.48, gastrinomas 0.65, carcinoid tumors 0.76, insulinomas 0.84, glucagonomas 0.93, and islet cell carcinomas 1.0. Conclusions When controlled for other established prognostic parameters, histopathologic subtype assignment of pancreatic ICTs affects survival prediction. Resection is associated with superior survival for all tumor types. J. Surg. Oncol. 2012; 105:595-600.

AB - Background The low incidence of malignant "functional" (F) or "nonfunctional" (NF) neuroendocrine islet cell tumors (ICTs) of the pancreas represents a challenge to precise post-therapeutic survival prediction. This study examined the survival impact of malignant pancreatic ICT morphologic subtypes. Methods A pancreatic ICT data set was created from a US-based population database from 1980-2004. Prognostic factors with survival impact and relationships between surgical therapy and overall survival (OS) were analyzed. Results There were 2,350 individuals with malignant ICTs. Histologic subtypes included carcinoid tumors, islet cell carcinomas, neuroendocrine carcinomas, and malignant gastrinomas, insulinomas, glucagonomas, or VIPomas. There was no difference in resection rates between FICTs and NFICTs (23% vs. 20%, P = ns). Median OS was 30 months, with group differences ranging from NE carcinomas (21) to VIPomas (96; P < 0.0001). Median OS of resected versus unresected FICTs was 172 versus 37 months, while that of NFICTs was 113 versus 18 months (P < 0.0001). Compared to neuroendocrine carcinomas, hazard ratios were: VIPomas 0.48, gastrinomas 0.65, carcinoid tumors 0.76, insulinomas 0.84, glucagonomas 0.93, and islet cell carcinomas 1.0. Conclusions When controlled for other established prognostic parameters, histopathologic subtype assignment of pancreatic ICTs affects survival prediction. Resection is associated with superior survival for all tumor types. J. Surg. Oncol. 2012; 105:595-600.

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