title: Nonfunctioning islet cell carcinoma of the pancreas: survival results in a contemporary series of 163 patients.
abstract: BACKGROUND
  The natural history of nonfunctioning islet cell carcinoma of the pancreas is poorly defined. We therefore reviewed our institutional experience during a period of 12 years to define more clearly the natural history of this disease as a basis for individual therapeutic recommendations.
  
  
  METHODS
  The records of all patients who had histologically or cytologically confirmed nonfunctioning islet cell carcinoma of the pancreas were retrospectively reviewed. Patients were grouped by extent of disease at diagnosis and by initial treatment. Survival distributions were estimated by Kaplan-Meier analysis.
  
  
  RESULTS
  One hundred sixty-three patients with nonfunctioning islet cell carcinoma of the pancreas were identified. The overall median survival duration was 3.2 years. The median survival was 7.1 years in patients with localized disease who underwent a potentially curative resection and 5.2 years in those with locally advanced, unresectable, nonmetastatic disease (P = .04). Patients with metastatic disease that could not be resected had a median survival of 2.1 years.
  
  
  CONCLUSIONS
  Patients with completely resected localized disease had a long median survival. Patients with nonmetastatic but unresectable locally advanced disease also had a surprisingly long median survival; major treatment-related morbidity may be hard to justify in this subgroup. The short median survival in patients with metastatic disease suggests that the frequent practice of observation in this patient subgroup needs to be reexamined and that continued investigation of regional and systemic therapies with novel agents is warranted.
authors.affiliation: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Tex. 77030, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Solorzano
authors.forename: J E
authors.initials: JE
authors.lastname: Lee
authors.forename: P W
authors.initials: PW
authors.lastname: Pisters
authors.forename: J N
authors.initials: JN
authors.lastname: Vauthey
authors.forename: G D
authors.initials: GD
authors.lastname: Ayers
authors.forename: M E
authors.initials: ME
authors.lastname: Jean
authors.forename: R F
authors.initials: RF
authors.lastname: Gagel
authors.forename: J A
authors.initials: JA
authors.lastname: Ajani
authors.forename: R A
authors.initials: RA
authors.lastname: Wolff
authors.forename: D B
authors.initials: DB
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018273:Carcinoma, Islet Cell / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000401:mortality*; D012189:Retrospective Studies