Bien E, Godzinski J, Dall'igna P, Defachelles AS, Stachowicz-Stencel T, Orbach D, Bisogno G, Cecchetto G, Warmann S, Ellerkamp V, Brennan B, Balcerska A, Rapala M, Brecht I, Schneider D, Ferrari A. Pancreatoblastoma: a report from the European cooperative study group for paediatric rare tumours (EXPeRT).
Eur J Cancer 2011;
47:2347-52. [PMID:
21696948 DOI:
10.1016/j.ejca.2011.05.022]
[Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 05/18/2011] [Accepted: 05/18/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND
Pancreatoblastoma is a very rare malignant tumour typically occurring in the early years of life. Due to its rarity, standardised diagnostic and therapeutic guidelines are not available for pancreatoblastoma.
METHODS
The newborn cooperative group denominated EXPeRT - European cooperative study group for paediatric rare tumours - combined in a joint analysis of all cases registered between 2000 and 2009 by the national groups of Italy, France, United Kingdom, Poland and Germany.
RESULTS
Twenty patients <18years old (median age 4years) were analysed: nine had distant metastases at diagnosis. Seventeen patients had tumour resection, at initial or delayed surgery. Eighteen received chemotherapy (response rate 73%), seven received radiotherapy. For the whole series, 5-year event-free survival and overall survival were 58.8% and 79.4%, respectively. Outcome did not correlate with tumour site and size, but was strongly influenced by the feasibility of tumour complete resection.
CONCLUSIONS
This international study confirms the rarity of the disease, the critical role of surgical resection both as therapy and as a prognostic variable, and the potential efficacy of chemotherapy. The adoption of an intensive multidisciplinary approach is required, as well as the referral to highly experienced centres. Further international cooperation is needed to collect larger series and stimulate biological studies to improve our understanding of the biology and the natural history of PBL.
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