Management of solid pseudopapillary neoplasms of pancreas: A single center experience of 243 consecutive patients

Liu, Mengqi; Liu, Jiang; Hu, Qiangsheng; Xu, Wei; Liu, Wensheng; Zhang, Zheng; Sun, Qiqing; Qin, Yi; Lei, Yu; Ji, Shunrong; Xu, Xiaorong

doi:10.1016/j.pan.2019.07.001

Cited by 48 publications

(67 citation statements)

References 29 publications

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“…The largest single-institution case series from Europe (n = 52) reported that the female-to-male ratio was 5.5:1 [8], and the ratio was 6.1:1 in the largest single-institution case series from the US (n = 78) [4]. A multicenter analysis in Korea reported that the female-to-male ratio was 9.3:1 [5], while a nationwide multicenter study in Japan and the largest single-institution case series from China (n = 243) found that the ratio was 3:1 [7,24]. The female-to-male ratio was 4:1 in our study, indicating a difference in incidence between different countries and races and that the number of male patients is increasing.…”

Section: Discussionmentioning

confidence: 95%

“…Dig Surg 2020;37:348-354 DOI: 10.1159/000505062 SPNs tend to occur in young women, with a mean age of 31-37 years [4][5][6][7]. SPNs have malignant potential, and approximately 9-28% of cases have malignant biological behavior [6,8] or malignant pathological features [5,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…The biological behavior and prognosis of SPNs are still difficult to predict, and pancreatic SPN is still an enigma [14,15]. Surgery remains the mainstay of therapy [6,7,16], but selection of surgical approaches is still under debate. Some authors have advocated function-preserving surgical approaches [7,10], while others favor aggressive surgical resection [17] or have considered parenchymapreserving resection as a significant risk factor for tumor recurrence [8].…”

Section: Introductionmentioning

confidence: 99%

“…Surgery remains the mainstay of therapy [6,7,16], but selection of surgical approaches is still under debate. Some authors have advocated function-preserving surgical approaches [7,10], while others favor aggressive surgical resection [17] or have considered parenchymapreserving resection as a significant risk factor for tumor recurrence [8]. In this study, we present the clinicopathological characteristics and surgical outcomes of 60 SPN patients from our center over a 10-year period and compare the short-term and long-term outcomes between conventional operations and parenchyma-preserving operations.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Lin

Lü

et al. 2020

Dig Surg

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Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, and the selection of surgical approaches is still under debate. The aim of this study was to analyze the clinicopathological characteristics and surgical outcomes of SPN patients and to compare the short-term and long-term outcomes between conventional operations and parenchyma-preserving operations. Methods: Patients who underwent pancreatic resection for SPNs between February 2010 and May 2019 in Fujian Medical University Union Hospital were identified. Clinicopathological details, perioperative data, and long-term follow-up results were retrospectively analyzed. Results: Sixty patients underwent surgical resection for SPNs during the study period: 48 females and 12 males. The mean age was 32.2 years. All patients underwent margin-negative surgical resection. The median follow-up period was 47 months (range: 3~118 months). One patient developed liver metastases 14 months after the operation and received local ablation therapy. All patients were alive during the follow-up. The incidence of postoperative pancreatic fistula was higher in the parenchyma-preserving surgery group than in the conventional surgery group (40.0 vs. 11.1%, p = 0.034). There was no significant difference in the tumor recurrence rate between the 2 groups. Eight (17.7%) and 6 patients (13.3%) in the conventional surgery group demonstrated endocrine and exocrine pancreatic insufficiency, respectively; furthermore, no patients in the parenchyma-preserving surgery group had endocrine or exocrine pancreatic insufficiency, but the incidences were not significantly different between the 2 groups. Conclusions: Margin-negative surgical resection of SPNs yields a very low rate of tumor recurrence and excellent long-term survival.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Lin

Lü

et al. 2020

Dig Surg

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“…Auch wenn hochwertige Studien oder große Fallserien fehlen, besteht in der Literatur Einigkeit, dass solide pseudopapilläre Neoplasien aufgrund ihres Malignitätspotenzials und des jungen Erkrankungsalters immer reseziert werden sollten [25 -27, 61, 62]. Dies gilt auch für maligne metastasierte SPN, da bei vollständiger Resektion des Primärtumors und der vorliegenden Metastasen hohe Überlebensraten erreicht werden können [63].…”

Section: Solide Pseudopapilläre Neoplasie (Spn)unclassified

Operationsindikationen bei zystischen Tumoren des Pankreas

et al. 2020

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ZusammenfassungEine stetige Verbesserung der modernen Bildgebung sowie ein steigendes Alter in der Gesellschaft haben dazu geführt, dass zunehmend häufiger zystische Pankreastumoren detektiert werden. Zystische Pankreasraumforderungen stellen eine klinisch herausfordernde Entität dar, da sie ein breites biologisches Spektrum umfassen und ihre Differenzierung untereinander vor allem bei kleinen Tumoren häufig schwierig ist. Sie bedingen daher eine differenzierte Operationsindikationsstellung. Zur Bestimmung von Empfehlungen zur Operationsindikation bei zystischen Tumoren des Pankreas wurde von einer Qualitätskommission für Pankreaserkrankungen der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie eine systematische Literaturrecherche durchgeführt und daraus resultierend folgende Übersichtsarbeit erstellt. Auf Grundlage der aktuellen Evidenz besteht bei Vorliegen von Malignitätszeichen oder Hochrisikokriterien (Ikterus bei Obstruktion des Ductus choledochus durch die zystische Pankreasläsion, kontrastmittelaufnehmende intramurale Knoten ≥ 5 mm oder solide Komponenten in der Zyste oder Pankreashauptgang ≥ 10 mm) sowie bei Symptomen unabhängig von der Zystenentität (ausgenommen Pankreaspseudozysten) eine Operationsindikation. Ist die Entität der Pankreaszyste mittels bildgebender Diagnostik eruierbar, so sollten alle intraduktalen papillär-muzinösen Neoplasien (IPMN) vom Hauptgang und vom Mischtyp, alle muzinös-zystischen Neoplasien (MCN) > 4 cm sowie alle soliden pseudopapillären Neoplasien (SPN) reseziert werden. Serös-zystische Neoplasien (SCN) und Seitengang-IPMN ohne Risikokriterien stellen primär keine Operationsindikation dar. Die Operationsindikationsstellung bei Seitengang-IPMN mit relativen Risikokriterien und MCN < 4 cm ist Gegenstand aktueller Diskussionen und sollte individuell erfolgen. Die vorliegende Arbeit soll durch ein Herausarbeiten von Indikationsempfehlungen helfen, die Indikationsqualität bei zystischen Pankreastumoren zu verbessern. Die letztendliche Operationsindikationsstellung sollte jedoch immer individualisiert unter Berücksichtigung von Alter, Komorbiditäten und Patientenwunsch erfolgen.

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Sex differences in solid pseudopapillary neoplasm of the pancreas: A population‐based study

Mao

Jiang

et al. 2020

Cancer Medicine

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Objective Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor. This study aims to examine the clinicopathological features and surgical treatments of SPN and compare the clinical behavior and prognosis between men and women with SPN. Methods We collected the population data of patients with SPN diagnosed between 2004 and 2017 from the SEER database. The Kaplan‐Meier method was used to analyze overall survival (OS) and disease‐specific survival (DSS), and log‐rank tests were used to evaluate the differences between subgroups. Univariate and multivariate Cox regression analyses were performed to screen out prognostic risk factors of SPN. Results A total of 378 patients with SPN were included, with 246 (65.1%) female patients. 1‐, 3‐, and 5‐year overall survival rates were 98.9%, 95.7%, and 93.7%, respectively. Survival analysis revealed that regardless of stage, patients with SPN who underwent surgical interventions still had a significantly better prognosis than those without surgical interventions ( P < .001). The patients with lymphatic dissection had a significantly better prognosis than those without lymphatic dissection ( P < .001). Moreover, compared with female patients, male patients had significantly poorer OS and DSS ( P < .001). Female SPN showed a bimodal age‐frequency distribution with early‐onset incidence at 28 years and late‐onset peak incidence at 62 years, while male SPN presented a unimodal distribution with peak incidence at approximately age 64 years. In female patients, the tumor size in premenopausal females (<65 years old) was significantly larger than that in postmenopausal females (≥65 years old) ( P < .001). Clinicopathological characteristic profiles were different not only between male SPN and premenopausal female SPN but also between premenopausal and postmenopausal female SPN. Conclusion SPN presents indolent behavior and predominantly occurs in young women. Regardless of stage, surgical intervention is recommended. Moreover, our study is the first large enough study to demonstrate sex‐related discrepancies in SPN. Thus, different treatment strategies should be designed for patients of different sexes at different ages and hormone therapy is a promising approach for SPN.

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Management of solid pseudopapillary neoplasms of pancreas: A single center experience of 243 consecutive patients

Cited by 48 publications

References 29 publications

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Surgical Management of Solid Pseudopapillary Neoplasms of Pancreas: A Single-Center Experience of 60 Patients

Operationsindikationen bei zystischen Tumoren des Pankreas

Sex differences in solid pseudopapillary neoplasm of the pancreas: A population‐based study

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