Resectable pancreatic small cell carcinoma

Jordan M. Winter, Amol K. Narang, Aaron S. Mansfield, Joseph M. Herman, John L. Cameron, Dan Laheru, Fred E. Eckhauser, Mathew T. Olson, Ralph H. Hruban, Robert C. Miller, Dana K. Andersen

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Primary pancreatic small cell carcinoma (SCC) is rare, with just over 30 cases reported in the literature. Only 7 of these patients underwent surgical resection with a median survival of 6 months. Prognosis of SCC is therefore considered to be poor, and the role of adjuvant therapy is uncertain. Here we report two institutions' experience with resectable pancreatic SCC. Six patients with pancreatic SCC treated at the Johns Hopkins Hospital (4 patients) and the Mayo Clinic (2 patients) were identified from prospectively collected pancreatic cancer databases and re-reviewed by pathology. All six patients underwent a pancreaticoduodenectomy. Clinicopathologic data were analyzed, and the literature on pancreatic SCC was reviewed. Median age at diagnosis was 50 years (range 27-60). All six tumors arose in the head of the pancreas. Median tumor size was 3 cm, and all cases had positive lymph nodes except for one patient who only had five nodes sampled. There were no perioperative deaths and three patients had at least one postoperative complication. All six patients received adjuvant therapy, five of whom were given combined modality treatment with radiation, cisplatin, and etoposide. Median survival was 20 months with a range of 9-173 months. The patient who lived for 9 months received chemotherapy only, while the patient who lived for 173 months was given chemoradiation with cisplatin and etoposide and represents the longest reported survival time from pancreatic SCC to date. Pancreatic SCC is an extremely rare form of cancer with a poor prognosis. Patients in this surgical series showed favorable survival rates when compared to prior reports of both resected and unresectable SCC. Cisplatin and etoposide appears to be the preferred chemotherapy regimen, although its efficacy remains uncertain, as does the role of combined modality treatment with radiation.

Original languageEnglish (US)
Pages (from-to)13-17
Number of pages5
JournalRare Tumors
Volume3
Issue number1
DOIs
StatePublished - 2011

Keywords

  • Carcinoma
  • Pancreas
  • Resectable
  • Small cell

ASJC Scopus subject areas

  • Histology
  • Oncology

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    Winter, J. M., Narang, A. K., Mansfield, A. S., Herman, J. M., Cameron, J. L., Laheru, D., Eckhauser, F. E., Olson, M. T., Hruban, R. H., Miller, R. C., & Andersen, D. K. (2011). Resectable pancreatic small cell carcinoma. Rare Tumors, 3(1), 13-17. https://doi.org/10.4081/rt.2011.e5