Konstantinos S Mylonas1, Dimitrios Nasioudis2, Diamantis I Tsilimigras3, Ilias P Doulamis4, Peter T Masiakos5, Cassandra M Kelleher6. 1. Department of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Surgery Working Group, Society of Junior Doctors, Menelaou 5 Street, 15123, Athens, Greece. Electronic address: kmylonas@mgh.harvard.edu. 2. Surgery Working Group, Society of Junior Doctors, Menelaou 5 Street, 15123, Athens, Greece; Department of Obstetrics and Gynecology, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA. Electronic address: dnasioudis@gmail.com. 3. Surgery Working Group, Society of Junior Doctors, Menelaou 5 Street, 15123, Athens, Greece; School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece. Electronic address: tsilidiam@hotmail.com. 4. Surgery Working Group, Society of Junior Doctors, Menelaou 5 Street, 15123, Athens, Greece. Electronic address: doulamis.i@gmail.com. 5. Department of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: pmasiakos@partners.org. 6. Department of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: ckelleher3@mgh.harvard.edu.
Abstract
PURPOSE: To examine the clinicopathological characteristics and prognosis of pediatric patients with malignant pancreatic tumors in a population-based cohort. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify all pediatric patients with malignant pancreatic tumors, diagnosed between 1973 and 2013. Kaplan-Meier analysis was performed to determine median and five-year overall survival (OS) rates. Univariate survival analysis was executed using the log-rank test. Cox proportional hazards model was used to identify variables independently associated with mortality. RESULTS: A total of 114 patients with pancreatic malignancies were identified. Median patient age was 16years and the majority of patients were white (64%) females (61.4%). The most prevalent histologic subtype was neuroendocrine tumors (35.1%), whereas pancreatoblastoma was more common during the first decade of life (P<0.001). Distant metastases were noted in 41.7% of the patients, while 33.3% and 25% had localized and regional disease respectively. Five-year OS rates were 77%, 66.4% and 64.8% for patients with pancreatoblastoma, neuroendocrine and epithelial tumors respectively. No death was observed in the solid pseudopapillary tumor group. Only history of having cancer-directed surgery (CDS) was significantly associated with lower overall mortality (HR: 5.1, 95% CI: 2.1, 12.4). CONCLUSION: Pancreatic malignancies are rare in children. Their prognosis is variable and only CDS was independently associated with superior survival. EVIDENCE RATING/CLASSIFICATION: Prognosis study, Level II.
PURPOSE: To examine the clinicopathological characteristics and prognosis of pediatric patients with malignant pancreatic tumors in a population-based cohort. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was utilized to identify all pediatric patients with malignant pancreatic tumors, diagnosed between 1973 and 2013. Kaplan-Meier analysis was performed to determine median and five-year overall survival (OS) rates. Univariate survival analysis was executed using the log-rank test. Cox proportional hazards model was used to identify variables independently associated with mortality. RESULTS: A total of 114 patients with pancreatic malignancies were identified. Median patient age was 16years and the majority of patients were white (64%) females (61.4%). The most prevalent histologic subtype was neuroendocrine tumors (35.1%), whereas pancreatoblastoma was more common during the first decade of life (P<0.001). Distant metastases were noted in 41.7% of the patients, while 33.3% and 25% had localized and regional disease respectively. Five-year OS rates were 77%, 66.4% and 64.8% for patients with pancreatoblastoma, neuroendocrine and epithelial tumors respectively. No death was observed in the solid pseudopapillary tumor group. Only history of having cancer-directed surgery (CDS) was significantly associated with lower overall mortality (HR: 5.1, 95% CI: 2.1, 12.4). CONCLUSION:Pancreatic malignancies are rare in children. Their prognosis is variable and only CDS was independently associated with superior survival. EVIDENCE RATING/CLASSIFICATION: Prognosis study, Level II.
Authors: Omar Picado; Anthony Ferrantella; Celisse Zabalo; Krishnamurti Rao; Chad M Thorson; Juan E Sola; Eduardo A Perez Journal: Pediatr Surg Int Date: 2020-01-27 Impact factor: 1.827