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Solid pseudopapillary tumors of the pancreas: Specific pathological features predict the likelihood of postoperative recurrence
Author(s) -
Marchegiani Giovanni,
Andrianello Stefano,
Massignani Marta,
Malleo Giuseppe,
Maggino Laura,
Paiella Salvatore,
Ferrone Cristina R.,
Luchini Claudio,
Scarpa Aldo,
Capelli Paola,
MinoKenudson Mari,
Lillemoe Keith D.,
Bassi Claudio,
Castillo Carlos Fernàndezdel,
Salvia Roberto
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24380
Subject(s) - medicine , pancreas , pathological , perineural invasion , incidence (geometry) , pancreatectomy , parenchyma , retrospective cohort study , radiology , surgery , general surgery , pathology , cancer , physics , optics
Background Since their introduction in the WHO classification, the incidence of solid pseudopapillary tumors (SPTs) of the pancreas has progressively increased, mainly because of the widespread use of cross‐sectional imaging. Few recent studies have analyzed the biological behavior of SPTs, but reliable data on long‐term follow‐up are needed. Methods Retrospective analysis of two Institutions with high caseload, The Department of General Surgery—Pancreas Institute, University of Verona Hospital Trust and the Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, was carried out. Data from 131 consecutive resections for SPT performed during the last three decades were collected and analyzed. Results The majority of patients were female (86.3%) with a median age of 33 (7–68) years. The prevalent location was the pancreatic tail (33.5%). Applying the WHO criteria, 16 (12.2%) SPTs were considered malignant due to the presence of at least pancreatic parenchyma (9.9%), perineural (4.6%), and/or angiovascular invasion (2.3%). After a median of 62 months after surgery, only two patients had a recurrence (1.5%). Both of them fulfilled the WHO criteria for malignant SPT (vs. 10.7% of those who did not recur, P = 0.01), had an infiltrative growth pattern (vs. 10.8%, P = 0.01), pancreatic parenchyma invasion (vs. 9.7%, P = 0.01) and capsular invasion (vs. 4.9%, P = 0.004). Conclusion Overall, SPTs are associated with excellent survival results after surgical resection. Disease recurrence is extremely rare, and might occur if the primary tumor presents with either pancreatic parenchyma or capsule invasion. J. Surg. Oncol. 2016;114:597–601 . © 2016 Wiley Periodicals, Inc.