Small Cell Carcinoma of the Pancreas: A Surgical Disease

Tommy Ivanics, John R. Bergquist, Christopher R. Shubert, Rory L. Smoot, Elizabeth B Habermann, Mark Truty

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES: Primary pancreatic small cell carcinomas (PSCCs) are rare, and benefits of surgery are unknown. Utilizing the National Cancer Data Base, surgical outcomes of PSCC were determined and compared with pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with histologically confirmed PSCC (n = 541) and PDAC (n = 156,733) were identified from the National Cancer Data Base (1998–2011). Parametric comparisons of patient and outcomes data were made. Unadjusted Kaplan-Meier and Cox proportional hazards analyses were performed. RESULTS: Primary pancreatic small cell carcinomas accounted for 0.2% of all pancreatic tumors. Demographics were similar to PDAC. A higher proportion of PSCC were metastatic at diagnosis (75.6% vs 53.6%, P <0.001). In stage I/II, 45.6% of PDAC versus 21.8% of PSCC underwent surgery. Node status, lymphovascular invasion, margin negativity rates, and perioperative outcomes were similar. Median unadjusted overall survival was similar for resected PDAC and PSCC (16.9 vs 20.7 months; P = 0.337). On multivariable analysis within resectable PSCC (stages I-II), the greatest independent predictors of mortality were age 65 years or older (hazards ratio, 2.78; 95% confidence interval, 1.56–4.97; P = 0.00055) and nonreceipt of surgery (hazards ratio, 2.66; 95% confidence interval, 1.24–5.71; P = 0.01). CONCLUSIONS: Although PSCC commonly presents with distant disease, patients with anatomically resectable tumors derive similar benefit from aggressive surgical intervention as PDAC and should be counseled accordingly.

Original languageEnglish (US)
JournalPancreas
DOIs
StateAccepted/In press - May 11 2016

Fingerprint

Small Cell Carcinoma
Pancreas
Adenocarcinoma
Neoplasms
Databases
Confidence Intervals
Demography
Survival
Mortality

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Small Cell Carcinoma of the Pancreas : A Surgical Disease. / Ivanics, Tommy; Bergquist, John R.; Shubert, Christopher R.; Smoot, Rory L.; Habermann, Elizabeth B; Truty, Mark.

In: Pancreas, 11.05.2016.

Research output: Contribution to journalArticle

Ivanics, Tommy ; Bergquist, John R. ; Shubert, Christopher R. ; Smoot, Rory L. ; Habermann, Elizabeth B ; Truty, Mark. / Small Cell Carcinoma of the Pancreas : A Surgical Disease. In: Pancreas. 2016.
@article{4217ea80e2fd44f984fe080da1ec5157,
title = "Small Cell Carcinoma of the Pancreas: A Surgical Disease",
abstract = "OBJECTIVES: Primary pancreatic small cell carcinomas (PSCCs) are rare, and benefits of surgery are unknown. Utilizing the National Cancer Data Base, surgical outcomes of PSCC were determined and compared with pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with histologically confirmed PSCC (n = 541) and PDAC (n = 156,733) were identified from the National Cancer Data Base (1998–2011). Parametric comparisons of patient and outcomes data were made. Unadjusted Kaplan-Meier and Cox proportional hazards analyses were performed. RESULTS: Primary pancreatic small cell carcinomas accounted for 0.2{\%} of all pancreatic tumors. Demographics were similar to PDAC. A higher proportion of PSCC were metastatic at diagnosis (75.6{\%} vs 53.6{\%}, P <0.001). In stage I/II, 45.6{\%} of PDAC versus 21.8{\%} of PSCC underwent surgery. Node status, lymphovascular invasion, margin negativity rates, and perioperative outcomes were similar. Median unadjusted overall survival was similar for resected PDAC and PSCC (16.9 vs 20.7 months; P = 0.337). On multivariable analysis within resectable PSCC (stages I-II), the greatest independent predictors of mortality were age 65 years or older (hazards ratio, 2.78; 95{\%} confidence interval, 1.56–4.97; P = 0.00055) and nonreceipt of surgery (hazards ratio, 2.66; 95{\%} confidence interval, 1.24–5.71; P = 0.01). CONCLUSIONS: Although PSCC commonly presents with distant disease, patients with anatomically resectable tumors derive similar benefit from aggressive surgical intervention as PDAC and should be counseled accordingly.",
author = "Tommy Ivanics and Bergquist, {John R.} and Shubert, {Christopher R.} and Smoot, {Rory L.} and Habermann, {Elizabeth B} and Mark Truty",
year = "2016",
month = "5",
day = "11",
doi = "10.1097/MPA.0000000000000661",
language = "English (US)",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Small Cell Carcinoma of the Pancreas

T2 - A Surgical Disease

AU - Ivanics, Tommy

AU - Bergquist, John R.

AU - Shubert, Christopher R.

AU - Smoot, Rory L.

AU - Habermann, Elizabeth B

AU - Truty, Mark

PY - 2016/5/11

Y1 - 2016/5/11

N2 - OBJECTIVES: Primary pancreatic small cell carcinomas (PSCCs) are rare, and benefits of surgery are unknown. Utilizing the National Cancer Data Base, surgical outcomes of PSCC were determined and compared with pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with histologically confirmed PSCC (n = 541) and PDAC (n = 156,733) were identified from the National Cancer Data Base (1998–2011). Parametric comparisons of patient and outcomes data were made. Unadjusted Kaplan-Meier and Cox proportional hazards analyses were performed. RESULTS: Primary pancreatic small cell carcinomas accounted for 0.2% of all pancreatic tumors. Demographics were similar to PDAC. A higher proportion of PSCC were metastatic at diagnosis (75.6% vs 53.6%, P <0.001). In stage I/II, 45.6% of PDAC versus 21.8% of PSCC underwent surgery. Node status, lymphovascular invasion, margin negativity rates, and perioperative outcomes were similar. Median unadjusted overall survival was similar for resected PDAC and PSCC (16.9 vs 20.7 months; P = 0.337). On multivariable analysis within resectable PSCC (stages I-II), the greatest independent predictors of mortality were age 65 years or older (hazards ratio, 2.78; 95% confidence interval, 1.56–4.97; P = 0.00055) and nonreceipt of surgery (hazards ratio, 2.66; 95% confidence interval, 1.24–5.71; P = 0.01). CONCLUSIONS: Although PSCC commonly presents with distant disease, patients with anatomically resectable tumors derive similar benefit from aggressive surgical intervention as PDAC and should be counseled accordingly.

AB - OBJECTIVES: Primary pancreatic small cell carcinomas (PSCCs) are rare, and benefits of surgery are unknown. Utilizing the National Cancer Data Base, surgical outcomes of PSCC were determined and compared with pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with histologically confirmed PSCC (n = 541) and PDAC (n = 156,733) were identified from the National Cancer Data Base (1998–2011). Parametric comparisons of patient and outcomes data were made. Unadjusted Kaplan-Meier and Cox proportional hazards analyses were performed. RESULTS: Primary pancreatic small cell carcinomas accounted for 0.2% of all pancreatic tumors. Demographics were similar to PDAC. A higher proportion of PSCC were metastatic at diagnosis (75.6% vs 53.6%, P <0.001). In stage I/II, 45.6% of PDAC versus 21.8% of PSCC underwent surgery. Node status, lymphovascular invasion, margin negativity rates, and perioperative outcomes were similar. Median unadjusted overall survival was similar for resected PDAC and PSCC (16.9 vs 20.7 months; P = 0.337). On multivariable analysis within resectable PSCC (stages I-II), the greatest independent predictors of mortality were age 65 years or older (hazards ratio, 2.78; 95% confidence interval, 1.56–4.97; P = 0.00055) and nonreceipt of surgery (hazards ratio, 2.66; 95% confidence interval, 1.24–5.71; P = 0.01). CONCLUSIONS: Although PSCC commonly presents with distant disease, patients with anatomically resectable tumors derive similar benefit from aggressive surgical intervention as PDAC and should be counseled accordingly.

UR - http://www.scopus.com/inward/record.url?scp=84966704687&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84966704687&partnerID=8YFLogxK

U2 - 10.1097/MPA.0000000000000661

DO - 10.1097/MPA.0000000000000661

M3 - Article

C2 - 27171519

AN - SCOPUS:84966704687

JO - Pancreas

JF - Pancreas

SN - 0885-3177

ER -