Nonendocrine cancer of the pancreas in patients under age forty years

E. J. Ivy, M. G. Sarr, H. M. Reiman

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62% of patients. 'Curative' resections were possible in only three patients (12%); the remaining patients underwent palliative bypass (38%), biopsy alone (42%), or a palliative resection (8%). The hospital mortality rate was 12%, with actual 1-, 2-, and 5-year survival rates of 19%, 8%, and 4%, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a 'solid and papillary neoplasm of the pancreas.' Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (> 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.

Original languageEnglish (US)
Pages (from-to)481-487
Number of pages7
JournalSurgery
Volume108
Issue number3
StatePublished - 1990

Fingerprint

Pancreatic Neoplasms
Adenocarcinoma
Pancreas
Neoplasms
Cystadenocarcinoma
Cystadenoma
Islet Cell Adenoma
Choledochal Cyst
Biopsy
Pancreatic Diseases
Head and Neck Neoplasms
Hospital Mortality
Jaundice
Pancreatitis
Abdominal Pain
Survivors
Weight Loss
Survival Rate
Head
Neoplasm Metastasis

ASJC Scopus subject areas

  • Surgery

Cite this

Ivy, E. J., Sarr, M. G., & Reiman, H. M. (1990). Nonendocrine cancer of the pancreas in patients under age forty years. Surgery, 108(3), 481-487.

Nonendocrine cancer of the pancreas in patients under age forty years. / Ivy, E. J.; Sarr, M. G.; Reiman, H. M.

In: Surgery, Vol. 108, No. 3, 1990, p. 481-487.

Research output: Contribution to journalArticle

Ivy, EJ, Sarr, MG & Reiman, HM 1990, 'Nonendocrine cancer of the pancreas in patients under age forty years', Surgery, vol. 108, no. 3, pp. 481-487.
Ivy EJ, Sarr MG, Reiman HM. Nonendocrine cancer of the pancreas in patients under age forty years. Surgery. 1990;108(3):481-487.
Ivy, E. J. ; Sarr, M. G. ; Reiman, H. M. / Nonendocrine cancer of the pancreas in patients under age forty years. In: Surgery. 1990 ; Vol. 108, No. 3. pp. 481-487.
@article{b14db569b2b54261bc857edd93953ac8,
title = "Nonendocrine cancer of the pancreas in patients under age forty years",
abstract = "In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62{\%} of patients. 'Curative' resections were possible in only three patients (12{\%}); the remaining patients underwent palliative bypass (38{\%}), biopsy alone (42{\%}), or a palliative resection (8{\%}). The hospital mortality rate was 12{\%}, with actual 1-, 2-, and 5-year survival rates of 19{\%}, 8{\%}, and 4{\%}, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a 'solid and papillary neoplasm of the pancreas.' Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (> 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.",
author = "Ivy, {E. J.} and Sarr, {M. G.} and Reiman, {H. M.}",
year = "1990",
language = "English (US)",
volume = "108",
pages = "481--487",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Nonendocrine cancer of the pancreas in patients under age forty years

AU - Ivy, E. J.

AU - Sarr, M. G.

AU - Reiman, H. M.

PY - 1990

Y1 - 1990

N2 - In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62% of patients. 'Curative' resections were possible in only three patients (12%); the remaining patients underwent palliative bypass (38%), biopsy alone (42%), or a palliative resection (8%). The hospital mortality rate was 12%, with actual 1-, 2-, and 5-year survival rates of 19%, 8%, and 4%, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a 'solid and papillary neoplasm of the pancreas.' Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (> 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.

AB - In an attempt to determine the natural history of ductal adenocarcinoma of the pancreas in patients under 40 years of age, we reviewed the surgical outcomes of all such patients seen at the Mayo Clinic from 1970 to 1985. Histologic sections were reviewed; islet cell tumors and cystadenocarcinomas were carefully excluded. Twenty-six patients were identified. Their mean age was 34 years, with only one patient less than 25 years old. Symptoms included primarily abdominal pain, weight loss, and jaundice. One third of patients had a recent or past history of pancreatic disease including pancreatitis, pseudocysts, benign cystadenoma, and choledochal cyst. The tumor was located in the head of the gland in 62% of patients. 'Curative' resections were possible in only three patients (12%); the remaining patients underwent palliative bypass (38%), biopsy alone (42%), or a palliative resection (8%). The hospital mortality rate was 12%, with actual 1-, 2-, and 5-year survival rates of 19%, 8%, and 4%, respectively, with a median survival of 4 months. The only long-term survivor underwent biliary bypass at age 15 years for a large neoplasm in the head of the gland; despite biopsy-proved liver metastases at that time, she continues to do well 5 years later. Histologic review indicated this tumor to be a 'solid and papillary neoplasm of the pancreas.' Ductal adenocarcinoma of the pancreas in young patients is an aggressive tumor with a poor prognosis behaving much like ductal adenocarcinoma in older patients (> 40 years). In rare instances a more favorable outcome can be expected when a solid and papillary neoplasm is found.

UR - http://www.scopus.com/inward/record.url?scp=0025062901&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025062901&partnerID=8YFLogxK

M3 - Article

C2 - 2168585

AN - SCOPUS:0025062901

VL - 108

SP - 481

EP - 487

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 3

ER -