Large tumor size, lymphovascular invasion, and synchronous metastasis are associated with the recurrence of solid pseudopapillary neoplasms of the pancreas. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Lee, Goeun; Sung, You-Na; Kim, Sung Joo; Lee, Jae Hoon; Song, Ki-Byung; Hwang, Dae Wook; Kim, Jihun; Lee, Sang Soo; Kim, Song Cheol; Hong, Seung-Mo
• Is Part Of: HPB. Volume 23:Issue 2(2021)
• Page Start: 220
• Page End: 230
• Publication Date: 2021-02
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2020.05.015
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas have low malignant potential. However, malignant SPNs are not fully understood. Methods: To evaluate risk factors affecting malignant potential, the clinicopathologic features of 375 surgically resected SPNs were compared. Results: Fifty (13.3%) had malignant histologic features. Twenty-seven and 22 had perineural and lymphovascular invasions, respectively. Adjacent organ invasion was noted in 9 cases. Recurrence occurred in 8 cases. The median recurrence time after surgical resection was 67 months and was associated with a higher pT category ( P = 0.001), lymphovascular invasion ( P < 0.001), and synchronous metastasis ( P < 0.001). SPN patients with malignant histologic features had worse recurrence-free survival (RFS; 10-year survival rate, 73.2%) than those without malignant histologic features (96.3%; P = 0.01). Patients with a higher pT category ( P = 0.04), synchronous metastasis ( P < 0.01), and lymphovascular invasion ( P < 0.01) had worse RFS. Lymphovascular invasion ( P = 0.042) and a higher T category ( P = 0.002) were poor prognostic factors for recurrence. Conclusion: Lymphovascular invasion and a higher T category were worse prognostic factors for recurrence in SPN patients with malignant histologic features. For SPN patients with malignant histologic features, a longer follow-up may be required.