Solid pseudopapillary neoplasms of the pancreas: an extended analysis of a single institution series after pancreatic resection

Abstract

P 86 SOLID PSEUDOPAPILLARY NEOPLASMS OF THE PANCREAS: AN EXTENDED ANALYSIS OF A SINGLE INSTITUTION SERIES AFTER PANCREATIC RESECTION J. Yu, Y. Y. Zhu, T. Saunders, L. D. Yin, J. Griffin, N. Pu, H. J. Hu, R. A. Burkhart, M. A. Makary, J. L. Cameron, M. J. Weiss, C. L. Wolfgang and J. He *Corresponding author. Yayun Zhu, Johns Hopkins University School of Medicine, United States Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas often put both patients and clinicians at a surgical dilemma. Few articles are currently available for surgeons to resort to for a convincing evaluation of the value of long-term postoperative follow-up which has been designated for more survival benefits. Methods: Data concerning relevant demographic, clinical, operative, and pathology were retrospectively collected for all patients with SPN who received surgical resection at the Johns Hopkins Hospital from July 1970 to July 2015. All data collected for this study, including long term survival information, came from the patient medical records and the US Social Security Death index. Perioperative surgical complications and mortalities and post-operative pancreatic were recorded. Statistical analysis was conducted using Standard Student t-test, and chi-squared analysis with IBM SPSS Statistics. A two-sided p < 0.05 were considered statistically significant. Results: A total number of seventy-nine patients with SPN, comprising 66 females (84%) and 13 males (16%) (p = 0.00). The median age for the total cohort was 33 years (Range: 6-75 years), 31 years and 35 years for females and males respectively. Thirty-two (41%) patients had complications, the most common of which were pancreatitis (n = 11, 14%), pancreatic fistula/leak (n = 6, 8%), delayed gastric emptying (DGE) (n = 6, 8%), abscess formation (n = 3, 4%), and wound infection (n = 5, 7%). Malignant characteristics were observed in 11 patients (five in the 13 male patients and six in the 66 female patients, p = 0.018). Two of the patients presented with liver metastasis, one of which passed away one year after diagnosis and the other survived for 5.6 years. Perineurial invasion was found in six, perivascular invasion in two, and lymph node involvement in three patients. All patients underwent a R0 resection except for three, two of which had R1 resections. The other patient underwent an R2 resection that ended up becoming a complete pancreatectomy. Three patients had lymphatic spread to regional lymph nodes. The median follow-up for the 79 patients is 6 years. Five patients died in the series, two of which died of liver metastasis, one died from Stage IV colorectal cancer at 1.5 years, and two died of unknown causes at 6.8 and 9.7 years respectively. The remaining 74 patients are alive including two patients with R1 resections who have been alive for 15.7 and 27 years respectively. Conclusion: SPNs are rare pancreas tumors that show predominance in females but are more likely to have malignant characteristics in males. Survival and outcome had no correlations to any preoperative, operative, or postoperative characteristics. This extensive follow up for patients with surgically resected SPNs supports the treatment of surgical resection and gives more insights into the follow up of patients with SPN, especially in males.