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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2017

01-07-2017 | Pancreatic Tumors

Analysis of 340 Patients with Solid Pseudopapillary Tumors of the Pancreas: A Closer Look at Patients with Metastatic Disease

Authors: Zeljka Jutric, MD, Yelena Rozenfeld, MPH, Jan Grendar, MD, Chet W. Hammill, MD, MCR, Maria A. Cassera, BS, Pippa H. Newell, MD, Paul D. Hansen, MD, Ronald F. Wolf, MD, FACS

Published in: Annals of Surgical Oncology | Issue 7/2017

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Abstract

Introduction

Current literature addressing the treatment of solid pseudopapillary neoplasms (SPNs) of the pancreas is limited, particularly for patients with distant metastases. We aimed to define predictive indicators of survival in a large series of patients and assess the outcome of patients with distant metastases.

Methods

The National Cancer Database was queried for patients diagnosed with SPNs of the pancreas between 1998 and 2011. Single predictor univariate analyses were performed on variables including demographics, tumor characteristics, and surgery outcomes, and multivariate Cox proportional hazards survival analysis was then completed with backward elimination.

Results

Overall, 340 patients were identified: 82% were female, median age was 39 years, and 84% had no comorbidities. Patients undergoing any type of surgical resection experienced long-term survival (85% 8-year survival). Patients undergoing surgical resection (n = 296) had superior survival (hazard ratio [HR] 21 for no surgery, p < 0.0001), as did patients treated at academic centers and those with private insurance (HR 3.9, p = 0.009; HR 4.9, p = 0.007). Sex, age, tumor size, presence of lymph node metastases, positive surgical margins, and presence of distant metastases were not significant predictors of survival in multivariate analysis. Of 24 patients with distant metastases, seven were treated surgically and experienced long-term survival similar to that of patients without metastases treated surgically (HR 2, p = 0.48).

Conclusion

SPNs of the pancreas are rare neoplasms with excellent overall survival; however, in a low number of patients they metastasize. Of the few patients with metastatic disease selected for resection, most experienced long-term survival.
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Metadata
Title
Analysis of 340 Patients with Solid Pseudopapillary Tumors of the Pancreas: A Closer Look at Patients with Metastatic Disease
Authors
Zeljka Jutric, MD
Yelena Rozenfeld, MPH
Jan Grendar, MD
Chet W. Hammill, MD, MCR
Maria A. Cassera, BS
Pippa H. Newell, MD
Paul D. Hansen, MD
Ronald F. Wolf, MD, FACS
Publication date
01-07-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 7/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5772-z

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