[Management of nonfunctioning islet cell tumors of the pancreas].
OBJECTIVE
To analyze the clinical and pathological features in order to investigate appropriate way of diagnosis and treatment for non-functional islet cell tumors of the pancreas (NFICT).


METHODS
The data and experience of surgically treated 43 patients with pathologically confirmed NFICT over the last 30 years were retrospectively reviewed. The survival rate was estimated using Kaplan-Meier method and the potential risk factors affecting survival were compared with Log rank test.


RESULTS
There were 7 males and 36 females in this series with a mean age of 31.6 years ranged from 8 to 67 years. Twenty-eight patients were diagnosed as having non-functional islet cell carcinomas of the pancreas (NFICC) and 15 patients benign islet cell tumors. The most common symptoms in NFICT were abdominal pain 55.8%, nausea and/or vomiting (32.6%), fatigue (25.6%) and abdominal mass (23.3%). Preoperatively, all of those were found to have a mass in their pancrease by ultrasonic and computed tomography examination, with 21 in the head, 10 in the body and 6 in the tail of the pancreas. Multicemtric tumor were found in one patient. Thirty-nine of these 43 patients (90.7%) underwent surgical resection, with a curative resection in 30 (69.8%) and palliative in 9 (20.9%). The resectability and curative resection rate in 28 patients with nonfunctioning islet cell carcinomas of the pancreas was 78.6% and 60.7%, respectively. None of the 15 patients with benign nonfunctioning islet cell tumor of the pancreas died of this disease. While the overall cumulative 5- and 10-year survival rate in 28 patients with non-functional islet cell carcinomas of the pancreas was only 58.1% and 29.0%, respectively. Curative resection, female, younger than 30 years old and mass diameter < 10 cm were found to be positive prognostic factors. But multivariate Cox regression analysis indicated that radical resection was the only independent prognostic factor (P = 0.007).


CONCLUSIONS
Nonfunctioning islet cell tumor of the pancreas is frequently found in young female. Surgical resection, especially curative resection can achieve satisfactory long-term survival.
Liang
Han
H
Department of Gastrointestinal Surgical Oncology, Tianjin Cancer Hospital, Tianjin Medical University, Tianjin 300060, China. tjlianghan@126.com
Wang
Xiao-Na
XN
Wang
Bao-Gui
BG
Pan
Yuan
Y
Ding
Xue-Wei
XW
Hao
Xi-Shan
XS
D007516:Adenoma, Islet Cell / Q000175:diagnosis / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018273:Carcinoma, Islet Cell / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D016577:Pancreaticoduodenectomy / Q000379:methods / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies
D016685:Mitomycin; D004317:Doxorubicin; D005472:Fluorouracil