Malignant pancreatic tumors: incidence and outcome in 58 pediatric patients

Eduardo A. Perez, Juan C. Gutierrez, Leonidas G. Koniaris, Holly L. Neville, William R. Thompson, Juan E. Sola

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)197-203
Number of pages7
JournalJournal of Pediatric Surgery
Volume44
Issue number1
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

Keywords

  • Pancreatic tumors
  • Pediatric
  • SEER registry
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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