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Malignant pancreatic tumors: incidence and outcome in 58 pediatric patients
Eduardo A Perez1, Juan C Gutierrez, Leonidas G Koniaris
1DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, FL 33136, USA.
Insights
Pediatric pancreatic cancer is rare, with exocrine tumors like solid-cystic tumors having better outcomes than ductal adenocarcinoma. Female sex and surgery independently improved survival rates in children with pancreatic malignancies.
Area of Science:
- Oncology
- Pediatric Oncology
- Cancer Epidemiology
Background:
- Pancreatic malignancies in children are rare but present unique challenges in diagnosis and treatment.
- Understanding incidence trends and prognostic factors is crucial for improving outcomes in pediatric patients.
Purpose of the Study:
- To investigate the current incidence trends of pancreatic malignancies in children.
- To analyze the outcomes and survival rates associated with pediatric pancreatic cancers.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) registry data from 1973-2004.
- Included pediatric patients (up to 19 years of age) diagnosed with pancreatic malignancies.
- Analyzed demographic, tumor type, metastasis, and survival data.
Main Results:
- Identified 58 pediatric pancreatic malignancy cases; incidence was higher in females and Asians.
- Exocrine tumors (31 cases) were most common, including pancreatoblastoma and solid-cystic tumors (SCTs).
- Distant metastasis occurred in nearly half of patients; female sex and surgery were significant predictors of improved survival (P < .001).
Conclusions:
- Pediatric pancreatic neoplasms are uncommon with variable prognoses.
- Female sex and surgical intervention are independent predictors of enhanced survival.
- Tumor type significantly impacts 15-year survival, with SCTs showing 100% and ductal adenocarcinoma 23% survival.
Objective:
The purpose of the study was to examine current incidence trends and outcomes for children with pancreatic malignancies.
Methods:
The Surveillance, Epidemiology, and End Results registry (1973-2004) was examined for pediatric patients with pancreatic malignancies (up to 19 years of age).
Results:
Malignant pancreatic neoplasms were identified in 58 patients. Females outnumbered males 1.9 to 1 (38 vs 20) for an age population-adjusted incidence of 0.021 and 0.015 per 100,000. Overall, 70% (n = 41) of patients were white. Asians had the highest incidence. Tumors were classified as exocrine (n = 31, 53.4%), endocrine (n = 19, 32.8%), or sarcomas (n = 5, 8.6%). Exocrine tumors included pancreatoblastoma (n = 10), solid-cystic tumor (SCT) (n = 10), ductal adenocarcinoma (DA) (n = 7), and acinar cell carcinoma (ACC) (n = 4). All SCTs and 80% of pancreatoblastomas were seen in females, whereas males had a higher incidence of DA 71% (P = .036). Ductal adenocarcinoma, SCT, acinar cell carcinoma, sarcomas, and endocrine tumors were more common in children older than 10 years, whereas pancreatoblastoma was more common in younger children (P = .045). Almost half of patients (n = 25) presented with distant metastasis; of these, 44% were endocrine tumors. Survival was significantly greater for female patients (P = .004) and for those who had surgery (P = .001) by both univariate and multivariate analysis. There was a significant difference in tumor type 15-year survival with DA having the worst (23%) and SCT the best (100%).
Conclusions:
Pediatric pancreatic neoplasms are uncommon and carry a variable prognosis. Both female sex and surgery were independent predictors of improved survival.
