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Nonfunctioning islet cell carcinoma of the pancreas
D B Evans1, J M Skibber, J E Lee
1Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Surgery
|December 1, 1993
Summary
Surgical resection improves survival for nonfunctioning islet cell carcinoma of the pancreas. Resection is rarely beneficial for metastatic disease, highlighting the need for new treatments for unresectable tumors.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Nonfunctioning islet cell carcinoma of the pancreas presents with variable clinical behavior.
- Treatment recommendations for this rare cancer are diverse due to its often indolent nature.
Purpose of the Study:
- To define the natural history of nonfunctioning islet cell carcinoma.
- To establish appropriate treatment guidelines based on institutional experience.
Main Methods:
- Retrospective review of patient records with confirmed nonfunctioning islet cell carcinoma.
- Kaplan-Meier survival analysis and log-rank comparisons.
Main Results:
- Overall 5-year survival was 50% in 73 patients.
- Localized disease (n=39) had better survival than metastatic disease (n=34) (p=0.03).
- Curative resection in 19 patients significantly improved survival compared to unresectable nonmetastatic disease.
Conclusions:
- Surgical resection is recommended for resectable, nonmetastatic pancreatic tumors.
- Primary tumor resection is seldom indicated when metastatic disease is present.
- Novel therapeutic strategies are required for unresectable, locally advanced pancreatic head tumors.