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Recurrence of Solid Pseudopapillary Neoplasms of the Pancreas: Results of a Nationwide Study of Risk Factors and Treatment Modalities
Author(s) -
Irtan Sabine,
GalmicheRolland Louise,
Elie Caroline,
Orbach Daniel,
Sauvanet Alain,
Elias Dominique,
Guérin Florent,
Coze Carole,
FaureConter Cécile,
Becmeur François,
Demarche Martine,
Galifer René Benoît,
Galloy Marie Agnès,
Podevin Guillaume,
Aubert Didier,
Piolat Christian,
Lagausie Pascal,
Sarnacki Sabine
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25986
Subject(s) - medicine , perioperative , surgery , chemotherapy , abdominal pain , pancreas
Background Solid pseudopapillary neoplasms of the pancreas (SPPN) can relapse very late, but little is known about risk factors for recurrence and optimal treatment. We aimed to identify risk factors for recurrence and to analyze treatment modalities in all French pediatric cases of SPPN over the past 20 years. Material and methods Data were collected from pediatric oncologists and surgeons, and also from adult pancreatic surgeons in order to identify late recurrences. Results Fifty‐one patients (41 girls) were identified. Median age at diagnosis was 13.1 years [8.7–17.9]. Abdominal pain was the commonest presenting symptom (32/49, 65%). The tumor was located in the pancreatic head in 24 patients (47%). Preoperative biopsy or cytology was performed in 14 cases (28%). All patients were operated with a median of 23 days [0–163] after diagnosis. The rate of postoperative morbidity was 29%. With a median follow‐up of 65 months [0.3–221], the overall and event‐free survival was 100% and 71%, respectively. Seven patients (13.7%) relapsed with a median of 43 months [33–94] after initial surgery. Six were treated surgically, either alone (n = 3) or with perioperative chemotherapy (n = 2) or hyperthermic intraperitoneal chemotherapy (n = 1). One patient in whom further treatment was not feasible was still alive at last news. Risk factors for recurrence were positive surgical margins ( P = 0.03) and age less than 13.5 years at diagnosis ( P = 0.03). Conclusions SPPN recurrence in this pediatric series was a rare and late event that did not undermine overall survival. Complete surgical removal of recurrent tumors appears to be the best option.