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Aggressiveness of solid pseudopapillary neoplasm of the pancreas: A literature review and meta-analysis

 Emmanuel II Uy Hao  ;  Ho Kyung Hwang  ;  Dong-Sub Yoon  ;  Woo Jung Lee  ;  Chang Moo Kang 
 MEDICINE, Vol.97(49) : e13147, 2018 
Journal Title
Issue Date
Carcinoma/diagnosis ; Carcinoma/physiopathology* ; Humans ; Neoplasm Invasiveness ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/physiopathology* ; Prognosis
BACKGROUND: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors considered to be benign although 10% to 15% of SPNs have been reported to be aggressive. Due to its rarity, there have only been a few cases reported regarding the clinical course of patients with aggressive SPNs. The goal of this study is to describe the clinical course of patients diagnosed with aggressive SPNs.

METHODS: A PubMed search was done looking for articles describing the clinical course of patients diagnosed with SPN that locally invaded, recurred, or metastasized. Institutional experience was also added to the pooled data. Patient information was extracted from the articles. Survival and recurrence curves were plotted and factors associated with survival and recurrences were analyzed.

RESULTS: A total of 59 patients were identified to have aggressive SPN. Seven patients were males and 52 were females and the mean age was 37.44 ± 2.21 years. Systemic metastasis constituted 81.4% while recurrence and deep tissue invasion were found in 11.9% and 6.8% of the patients, respectively. Disease-free survival was 45 ± 6.28 months and disease-specific survival was 152.67 ± 12.8 months. In survival analysis, age, gender, tumor size, tumor location, combined resection, type of recurrence, and stage IV on diagnosis were not significant factors in predicting survival. However, an unresectable tumor (hazards ratio [HR] = 4.871, 95% confidence interval [CI] 1.480-16.03, P = .009), and metastasis within 36 months (HR = 6.399, 95% CI: 1.390-29.452, P = .017) were identified as independent variables in predicting survival.

CONCLUSION: SPNs of the pancreas carry a favorable course. Despite having aggressive properties, patients can still survive for more than 10 years as long as the tumor can be resected completely.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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