Tumors of the endocrine pancreas are a collection of tumor cell types collectively referred to as pancreatic neuroendocrine tumors (NETs). These tumors originate in islet cells. Although they may be similar or identical in histologic appearance to carcinoid tumors of the gastrointestinal tract, differences in their underlying biology and likely differences in response to therapeutic agents suggest that they should be treated and investigated as a distinct entity. They are uncommon cancers with about 1,000 new cases per year in the United States. They account for 3% to 5% of pancreatic malignancies and overall have a better prognosis than the more common pancreatic exocrine tumors.[2,3] Five-year survival is about 55% when the tumors are localized and resected but only about 15% when the tumors are not resectable. Overall 5-year survival rate is about 42%.Figure 1. Cancer of the Pancreas: Relative Survival Rates (%) by Histologic Subtype, Ages 20+, 12 SEER Areas,
There is no established therapy for pancreatic neuroendocrine tumors that recur or progress after prior therapy. Deciding on further treatment depends on many factors, including:The specific cancer.Prior treatment.Site of recurrence.Individual patient considerations.Attempts at re-resection of local tumors that have recurred or metastatic lesions may offer palliation, when technically feasible. Intra-arterial chemotherapy is a consideration for patients with liver metastases. Patients with hepatic-dominant disease and substantial symptoms caused by tumor bulk or hormone-release syndromes may benefit from continuous-infusion intra-arterial chemotherapy or procedures that reduce hepatic arterial blood flow to metastases (hepatic arterial occlusion with embolization or with chemoembolization).[2,3,4,5,6,7] Such treatment may also be combined with systemic chemotherapy. A variety of systemic agents have shown biologic or palliative activity,[1,8] including:Somatostatin
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment
Pancreatic cancer is a disease in which malignant (cancer) cells form in the tissues of the pancreas. The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head,the middle section is called the body,and the narrow end is called the tail. The pancreas lies behind the stomach and in front of the spine. The ...
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.
Related Summary Note: Another PDQ summary containing information related to pancreatic cancer includes: Unusual Cancers of Childhood (pancreatic cancer in children) Statistics Note: Estimated new cases and deaths from pancreatic cancer in the United States in 2010:[ 1 ] New cases: 43,140. Deaths: 36,800. Note: Some citations in the text of this section are followed by a level of evidence. The ...
About PDQPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.Purpose of This SummaryThis PDQ cancer information summary has current
Treatment Options for Stages I and II Pancreatic CancerTreatment options for stages I and II pancreatic cancer include the following:Surgery: radical pancreatic resection including:Whipple procedure (pancreaticoduodenal resection).Total pancreatectomy when necessary for adequate margins.Distal pancreatectomy for tumors of the body and tail of the pancreas.[1,2]Postoperative chemoradiation therapy: radical pancreatic resection followed by 5-fluorouracil (5-FU) chemotherapy and radiation therapy.[3,4,5,6,7]Postoperative chemotherapy: radical pancreatic resection followed by chemotherapy (gemcitabine or 5-FU/leucovorin).Surgery Complete resection can yield 5-year survival rates of 18% to 24%, but ultimate control remains poor because of the high incidence of both local and distant tumor recurrence.[9,10,11][Level of evidence: 3iA]Approximately 20% of patients present with pancreatic cancer amenable to local surgical resection, with operative mortality rates of