title: Surgical resection and multidisciplinary care for primary and metastatic pancreatic islet cell carcinomas.
abstract: BACKGROUND
  The role of multidisciplinary management of islet cell cancers (ICC) has not been fully investigated in a population-based setting.
  
  
  METHODS
  The Los Angeles County Cancer Surveillance Program was assessed for patients with ICC between the years 1982 to 2006. Patients were stratified by treatment received and clinicopathologic characteristics and survival were compared.
  
  
  RESULTS
  We identified 236 patients with ICC; 86 patients underwent curative-intent surgery with median survival for local, regional, and distant disease of 17.3, 12.2, and 4.0 years, respectively. In comparison, 102 patients underwent medical management alone; survival was significantly shorter when compared to the surgical cohort for local, regional, and distant disease (p < 0.05). To determine whether adjuvant chemotherapy was associated with improved survival, we compared patients who underwent surgery alone compared to patients who underwent surgery followed by adjuvant chemotherapy. Although patients with metastatic disease had 3-year longer survival with adjuvant chemotherapy, these improvements in survival were not statistically significant.
  
  
  CONCLUSIONS
  Surgical resection was associated with improved survival compared to medical management for any extent of disease in patients with ICC. Furthermore, adjuvant chemotherapy was not associated with survival but does warrant further examination in patients with metastatic disease.
authors.affiliation: Department of Oncologic Surgery, City of Hope Comprehensive Cancer Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
authors.forename: Shaun
authors.initials: S
authors.lastname: McKenzie
authors.forename: Wendy
authors.initials: W
authors.lastname: Lee
authors.forename: Avo
authors.initials: A
authors.lastname: Artinyan
authors.forename: Brian
authors.initials: B
authors.lastname: Mailey
authors.forename: Alessio
authors.initials: A
authors.lastname: Pigazzi
authors.forename: Joshua
authors.initials: J
authors.lastname: Ellenhorn
authors.forename: Joseph
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018273:Carcinoma, Islet Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate