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

  • Pancreatic Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

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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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Disclosures

Zeljka Jutric, Yelena Rozenfeld, Jan Grendar, Chet W. Hammill, Maria A. Cassera, Pippa H. Newell, Paul D. Hansen, and Ronald F. Wolf have no disclosures.

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Authors and Affiliations

  1. Liver and Pancreas Surgery, Portland Providence Cancer Institute, Portland, OR, USA

    Zeljka Jutric MD, Jan Grendar MD, Maria A. Cassera BS, Pippa H. Newell MD, Paul D. Hansen MD & Ronald F. Wolf MD, FACS

  2. Providence Health and Services, Renton, WA, USA

    Yelena Rozenfeld MPH

  3. Division of Liver and Pancreas Surgery, The Oregon Clinic, Portland, OR, USA

    Chet W. Hammill MD, MCR, Pippa H. Newell MD, Paul D. Hansen MD & Ronald F. Wolf MD, FACS

Authors
  1. Zeljka Jutric MD
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  2. Yelena Rozenfeld MPH
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  3. Jan Grendar MD
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  4. Chet W. Hammill MD, MCR
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  5. Maria A. Cassera BS
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  6. Pippa H. Newell MD
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  7. Paul D. Hansen MD
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  8. Ronald F. Wolf MD, FACS
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Corresponding author

Correspondence to Ronald F. Wolf MD, FACS.

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Jutric, Z., Rozenfeld, Y., Grendar, J. et al. Analysis of 340 Patients with Solid Pseudopapillary Tumors of the Pancreas: A Closer Look at Patients with Metastatic Disease. Ann Surg Oncol 24, 2015–2022 (2017). https://doi.org/10.1245/s10434-017-5772-z

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  • DOI: https://doi.org/10.1245/s10434-017-5772-z

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