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Treatment patterns and outcomes for pancreatic tumors in children: an analysis of the National Cancer Database

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Abstract

Purpose

Pancreatic tumors are rare in children and limited data are available regarding incidence, treatment, and outcomes. We aim to describe patient and tumor characteristics and to report on survival of these diseases.

Methods

Children with pancreatic tumors were queried from the National Cancer Database (2004–2014). The association between treatment and hazard of death was assessed using Kaplan–Meier method and Cox regression model.

Results

We identified 109 children with pancreatic tumors; 52% were male and median age at diagnosis was 14 years. Tumors were distributed as follows: pseudopapillary neoplasm (30%), endocrine tumors (27%), pancreatoblastoma (16%), pancreatic adenocarcinoma (16%), sarcoma (6%) and neuroblastoma (5%). Seventy-nine patients underwent surgery, of which 76% achieved R0 resection. Most patients (85%) had lymph nodes examined, of which 22% had positive nodes. Five-year overall survival by tumor histology was 95% (pseudopapillary neoplasm), 75% (neuroblastoma), 70% (pancreatoblastoma), 51% (endocrine tumors), 43% (sarcoma), and 34% (adenocarcinoma). On multivariable analysis, surgical resection was the strongest predictor of survival (HR 0.26, 95% CI 0.10–0.68, p < 0.01).

Conclusion

Overall survival of children with pancreatic tumors is grim, with varying survival rates among different tumors. Surgical resection is associated with improved long-term survival.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA

    Omar Picado, Anthony Ferrantella, Celisse Zabalo, Krishnamurti Rao, Chad M. Thorson, Juan E. Sola & Eduardo A. Perez

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  1. Omar Picado
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  2. Anthony Ferrantella
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  3. Celisse Zabalo
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  4. Krishnamurti Rao
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  5. Chad M. Thorson
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  6. Juan E. Sola
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  7. Eduardo A. Perez
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Contributions

OP and EAP contributed to the study conception and design and performed the data collection and analysis; OP, AF, CZ, and KR prepared the manuscript; CMT, JES, and EAP provided critical revisions to the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eduardo A. Perez.

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Picado, O., Ferrantella, A., Zabalo, C. et al. Treatment patterns and outcomes for pancreatic tumors in children: an analysis of the National Cancer Database. Pediatr Surg Int 36, 357–363 (2020). https://doi.org/10.1007/s00383-020-04617-z

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  • DOI: https://doi.org/10.1007/s00383-020-04617-z

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