Prediction of malignancy and adverse outcome of solid pseudopapillary tumor of the pancreas

Li, You; Yang, Feng; Fu, Deliang

doi:10.4251/wjgo.v10.i7.184

Cited by 38 publications

(42 citation statements)

References 65 publications

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“…The survival rates in this study remain either comparable to or surpass the survival rates of patients with intraductal papillary mucinous neoplasm and concurrent extra‐pancreatic tumours or patients with PDAC alone . The improved survival figures in the present cohort are likely influenced by the fact that some of these patients had pancreatic tumours with more favourable prognostic outcomes such as solid pseudopapillary neoplasms and ampullary carcinomas …”

Section: Discussionsupporting

confidence: 49%

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Mehta

Tan

Nahm

et al. 2020

ANZ Journal of Surgery

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Background Patients may present with a resectable pancreatic tumour in the context of a concurrent primary extra‐pancreatic malignancy. These patients pose a dilemma regarding their suitability for surgery. We evaluated our experience with such patients who underwent pancreatic resection with curative intent and detailed their outcomes and rationale for surgical decision‐making. Methods A retrospective review of patients with pancreatic concurrent extra‐pancreatic primary malignancy who underwent pancreatic resection at our institution over a 12‐year period (2005–2016) was performed. Clinical, histopathological and perioperative outcomes were reviewed. Results Ten patients with a median age of 74 years (40–85 years) were identified. Secondary primary tumours included thyroid (n = 2), gastrointestinal (n = 4), small bowel neuroendocrine (n = 1), renal (n = 1) and haematological malignancies (n = 2). Pancreatic tumours included pancreatic ductal adenocarcinomas (n = 6), solid pseudopapillary neoplasms (n = 2) and ampullary carcinomas (n = 2). After a median follow up of 41.3 months (31.3–164 months), 8 of 10 patients were still alive. Two patients died due to metastatic disease from the secondary malignancy (small bowel neuroendocrine tumour and sigmoid colon adenocarcinoma). The post‐operative complication rate was 30% with no perioperative 90‐day mortality. Conclusion Selected patients with a pancreatic and concurrent primary extra‐pancreatic malignancy may undergo curative pancreatic resection with favourable outcomes.

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Section: Discussionsupporting

confidence: 49%

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Mehta

Tan

Nahm

et al. 2020

ANZ Journal of Surgery

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“…The natural history and biological behavior of SPTP are difficult to determine. Malignant SPTP is frequently challenging to accurately diagnose, both clinically and radiologically, except in those with distant metastasis or with tumor invasion into adjacent structures . In this study, only 14.2% of patients meeting the criteria for malignancy.…”

Section: Discussionmentioning

confidence: 66%

“…It is usually detected by cross‐sectional imaging such as computed tomography (CT) and magnetic resonance imaging. As the incidence of pancreatic tumors increases in China, the number of patients with SPTP has continued to grow . The natural history of SPTP is highly variable, with most of them manifesting with an indolent course, while others are associated with local invasion and distant metastasis …”

Section: Introductionmentioning

confidence: 99%

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Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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Background Systemic inflammatory markers such as neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have been shown to be prognostic for many types of pancreatic malignancy. The aim of this study was to evaluate the prognostic role of these markers in patients with solid pseudopapillary tumor of the pancreas (SPTP). Methods Patients who underwent surgical resection for histologically confirmed SPTP were retrospectively reviewed in our institution. Preoperative NLR and PLR were calculated. Clinicopathologic data were correlated with the presence of malignant potential and recurrence‐free survival (RFS). Results A total of 113 patients with SPTP were included in this study. Of them, 23 were men and 90 were women, with a median age of 35 years (interquartile range, 25‐44). The optimal cut‐off values for malignant SPTP were 3.22 for NLR, and 75.5 for PLR, respectively. Univariate analysis showed that high NLR (>3.22) and white blood cell count more than 9.96 × 109/L were predictive of a malignant SPTP. Meanwhile, high NLR (P = 0.001) and age more than 35 years (P = 0.026) were associated with worse RFS. On multivariable analyses, high NLR was the only independent predictor of malignant SPTP (odd ratio 6.871; 95% confidence interval [CI], 1.482‐31.864; P = 0.014) and RFS (hazard ratio 12.633; 95% CI, 1.758‐90.790; P = 0.012). Conclusions This study highlights the supportive role of preoperative NLR in predicting malignancy and RFS of SPTP patients. Further studies including a larger cohort of patients are needed to corroborate our findings.

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“…14,37 An advantage of the Warshaw technique is that the vascular dissection is remote from cancer. 39,40 However, the actual rates for pathologic venous invasion in patients underwent the Warshaw and conventional operations were similar (70.6% vs 71.4%). Spleen-preserving total pancreatectomy utilizing the Warshaw technique, even by minimally invasive approach, has been thought to be feasible, safe, and effective in selected patients.…”

Section: Resultsmentioning

confidence: 92%

Total pancreatectomy for pancreatic malignancy with preservation of the spleen

Yang

Jin

Warshaw

et al. 2019

Journal of Surgical Oncology

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Background Total pancreatectomy may be necessary to achieve margin‐negative resection for pancreatic cancer. However, despite the desirability of saving the spleen, the feasibility, safety, and oncological outcomes of spleen‐preserving total pancreatectomy have not been studied in patients with malignancy involving the pancreatic neck or proximal body. The aim of this study was to report the efficacy of spleen‐preserving total pancreatectomy using the Warshaw technique for patients with pancreatic malignancies. Methods A retrospective analysis of patients who underwent total pancreatectomy for malignant pancreatic diseases between December 2006 and January 2018 focused on comparing the clinical outcomes between conventional operations with splenectomy and spleen‐preserving total pancreatectomy using the Warshaw technique. Results Thirty‐eight patients among a total of 59 total pancreatectomies had the spleen preservation by the Warshaw operation. In this series, the pancreatic ductal adenocarcinomas resected with the Warshaw technique were of smaller tumor size but had greater rates of vascular invasion, resulting in the more frequent vascular resection. No patients had splenic complications requiring splenectomy, but two patients intended to have the Warshaw operation were converted to splenectomy because of splenic malperfusion. Asymptomatic perigastric varices were noted in 4 patients. Postoperative morbidity and mortality were comparable between the Warshaw and conventional operation groups. Recurrence‐free and overall survival was similar in both groups. Conclusion In patients with pancreatic malignancy, total pancreatectomy with preservation of the spleen using the Warshaw technique achieves outcomes comparable with conventional total pancreatectomy with splenectomy in selected patients.

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Prediction of malignancy and adverse outcome of solid pseudopapillary tumor of the pancreas

Cited by 38 publications

References 65 publications

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Pancreatic resection in patients with synchronous extra‐pancreatic malignancy: outcomes and complications

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Total pancreatectomy for pancreatic malignancy with preservation of the spleen

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