Pancreaticoduodenectomy for malignancies in children

D’Ambrosio, Giuseppe; Prete, Laura Del; Grimaldi, Chiara; Bertocchini, Arianna; Zupone, Cristina Lo; Monti, Lidia; Goyet, Jean de Ville de

doi:10.1016/j.jpedsurg.2013.09.010

Cited by 26 publications

(21 citation statements)

References 10 publications

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“…Comparing our data to similarly high-risk patients who underwent PD, a recent retrospective review from Italy in 2014 described the records of 5 pediatric patients[3]. These patients presented with SPT (n=1), rhabdomyosarcoma (n=2), and pancreatic endocrine neoplasia (n=2).…”

Section: Discussionmentioning

confidence: 82%

“…Pancreaticoduodenectomy is an exceedingly rare procedure performed in the pediatric population[3, 8, 14]. We present our series of 12 patients who underwent PD at our institution over the last 21 years.…”

Section: Discussionmentioning

confidence: 99%

“…Pancreatic and biliary pathology are very rare among the pediatric population[1-3]. Even rarer is the small patient subset that requires a pancreaticoduodenectomy (PD) to treat the disease process.…”

Section: Introductionmentioning

confidence: 99%

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Pancreaticoduodenectomy for pediatric and adolescent pancreatic malignancy: A single-center retrospective analysis

Lindholm

Alkattan

Abramson

et al. 2017

Journal of Pediatric Surgery

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Purpose While pancreaticoduodenectomy (PD) has been extensively studied in adults, there are few data pertaining specifically to pediatric patients. We retrospectively analyzed PD-associated morbidity and mortality in pediatric patients. Methods Our analytic cohort included all consecutive patients ≤18 years of age treated at our institution from 1993-2015 who underwent PD. Patient data (demographics, disease characteristics, surgical and adjuvant treatment, length of hospital stay, and postoperative course) were extracted from the medical records. Results We identified 12 children with a median age of 9 years (7 female, 5 male). Final diagnoses were pancreatoblastoma (n=3), solid pseudopapillary tumor (n=3), neuroblastoma (n=2), rhabdomyosarcoma (n=2), and neuroendocrine carcinoma (n=2). Four patients underwent PD for resection of recurrent disease. 75% (9/12 patients) received neoadjuvant therapy. The median operative time was approximately 7 hours with a mean blood loss of 590cc. The distal pancreas was invaginated into the posterior stomach (n=3), into the jejunum (n=5) or directly sewn to the jejunal mucosa (n=4). There were no operative deaths. There were 4 patients (34%) with Grade II complications, 1 with a Grade IIIb complication (chest tube), and 1 with a Grade IV complication (re-exploration). The most common long-term morbidity was pancreas exocrine supplementation (n=10; 83%). Five patients (42%) diagnosed with either solid pseudopapillary tumor or rhabdomyosarcoma are currently alive with a mean survival of 77.4 months. Conclusion Pancreaticoduodenectomy is a feasible management strategy for pediatric pancreatic malignancies and is associated with acceptable morbidity and overall survival. Long-term outcome is most dependent on histology of the tumor. Level of Evidence IV

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Pancreaticoduodenectomy for pediatric and adolescent pancreatic malignancy: A single-center retrospective analysis

Lindholm

Alkattan

Abramson

et al. 2017

Journal of Pediatric Surgery

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“…[6,15] This helps to explain why so few studies of pancreatic cancer in adolescents have been reported, [7,10,12,16] and this lack of knowledge means that optimal treatments for such patients is unclear. In this analysis of such patients treated at our institution over a 15-year period, we found that radical resection did not increase risk of serious complications or disturb growth and development.…”

Section: Discussionmentioning

confidence: 99%

“…[1–3,15] Radical primary intervention is associated with favorable outcomes in patients with no regional or metastatic extension. [16] Indeed, radical resection is associated with better OS and RFS than nonradical alternatives in patients with various types of malignant or benign pancreatic tumors. [34] …”

Section: Discussionmentioning

confidence: 99%

Radical resection and enucleation in Chinese adolescents with pancreatic tumors

Yang

Xie²,

Jin³

et al. 2017

Medicine

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Pancreatic tumors rarely occur in adolescents, and the appropriateness of radical resection for these patients remains controversial.Medical records were retrospectively reviewed for patients younger than 19 years who underwent radical resection or limited resection (enucleation) between 2000 and 2015. Patient demographics, clinical characteristics, operative details, growth, and survival were analyzed.During the study period, 11 adolescents (mean age, 16.18 years; standard deviation, 1.99; interquartile range, 15.0–18.0) underwent radical resection (n = 7) or enucleation (n = 4) to treat solid pseudopapillary tumors (n = 5), pancreatic neuroendocrine tumors (n = 5), or pancreatic ductal adenocarcinoma (n = 1). None of the 7 patients who underwent radical resection experienced recurrence or serious complications, while 3 of 4 patients who underwent enucleation experienced recurrence (P = 0.02). Recurrence-free survival was slightly longer in patients who underwent radical resection, and this procedure did not appear to affect adolescent growth and development.Radical resection might be safe and effective for adolescents with pancreatic tumors.

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Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

Crocoli

Grimaldi

Virgone

et al. 2018

Pediatric Blood & Cancer

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Background Solid pseudopapillary pancreatic tumors (SPPT) are an extremely rare entity in pediatric patients. Even if the role of radical surgical resection as primary treatment is well established, data about follow‐up after pancreatic resection in children are scant. Methods A retrospective review of data from the Italian Pediatric Rare Tumor Registry (TREP) was performed. Short‐term (<30 days) and long‐term complications of different surgical resections, as well as long‐term follow‐up were evaluated. Results From January 2000 to present, 43 patients (male:female = 8:35) were enrolled. The median age at diagnosis was 13.2 years (range, 7–18). Nine children had an incidental diagnosis, whereas 26 complained of abdominal pain and 4 of palpable mass. Tumors arose either from the head of pancreas (n = 14) or from body/tail (n = 29): only one patient presented with metastatic disease. Resection was complete in all patients (cephalic duodenopancreatectomy vs distal resection). At follow‐up (median, 8.4 years; range, 0–17 years), one recurrence occurred in a patient with intraoperative rupture. All patients are alive. Three pancreatic fistulas occurred in the body/tail group, whereas four complications occurred in the head group (one ileal ischemia, two stenosis of the pancreatic duct, and one chylous fistula). Conclusion Surgery is the best therapeutic option for these tumors; hence, complete resection is mandatory. Extensive resections, including cephalic duodenopancreatectomy, are safe when performed in specialized centers. Long‐term follow‐up should be aimed to detect tumor recurrence and to evaluate residual pancreatic function.

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Pancreaticoduodenectomy for malignancies in children

Cited by 26 publications

References 10 publications

Pancreaticoduodenectomy for pediatric and adolescent pancreatic malignancy: A single-center retrospective analysis

Pancreaticoduodenectomy for pediatric and adolescent pancreatic malignancy: A single-center retrospective analysis

Radical resection and enucleation in Chinese adolescents with pancreatic tumors

Outcome after surgery for solid pseudopapillary pancreatic tumors in children: Report from the TREP project—Italian Rare Tumors Study Group

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