Outcome and prognosis after pancreatectomy in patients with solid pseudopapillary neoplasms

• Verfasst von: Tjaden, Christin [VerfasserIn]
• Verfasst von: Hassenpflug, Matthias [VerfasserIn]
• Verfasst von: Hinz, Ulf [VerfasserIn]
• Verfasst von: Klaiber, Ulla [VerfasserIn]
• Verfasst von: Klauß, Miriam [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Hackert, Thilo [VerfasserIn]
• Titel: Outcome and prognosis after pancreatectomy in patients with solid pseudopapillary neoplasms
• Verf.angabe: Christine Tjaden, Matthias Hassenpflug, Ulf Hinz, Ulla Klaiber, Miriam Klauss, Markus W. Büchler, Thilo Hackert
• E-Jahr: 2019
• Jahr: 14 June 2019
• Umfang: 11 S.
• Fussnoten: Gesehen am 04.12.2019
• Titel Quelle: Enthalten in: Pancreatology
• Ort Quelle: Amsterdam : Elsevier, 2001
• Jahr Quelle: 2019
• Band/Heft Quelle: 19(2019), 5, Seite 699-709
• ISSN Quelle: 1424-3911
• DOI: doi:10.1016/j.pan.2019.06.008
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Follow-up
• Sach-SW: Frantz tumor
• Sach-SW: Malignancy
• Sach-SW: Metastases
• Sach-SW: Pancreas resection
• K10plus-PPN: 1684166802

Abstract

Background - Solid pseudopapillary neoplasms (SPN) are rare and represent approximately 4% of all cystic pancreatic tumors. The prognosis is excellent, although 10-15% of SPN patients show metastasis at the time of surgery or tumor recurrence during follow-up after pancreatectomy. Aim of the study was to analyze surgical management, risk factors for malignancy as well as long-term outcome and prognosis of this distinct tumor entity. - Method - All patients with pancreatic resection for SPN between 10/2001 and 07/2018 in the authors’ institution were identified from a prospective database. Clinicopathologic details, perioperative data and long-term follow-up results were retrospectively analyzed. - Results - Fifty-two patients were identified, 44 (85%) of them were female and the median age was 29 years (IQR 9-71). Seven (13%) patients showed a malignant behaviour of SPN with N1 (n=2) or M1 (n=1) disease at resection; 5 patients developed tumor recurrence, after a median of 21 months. During follow-up time (median 54 months) all patients were alive, the 5- and 10-year rates for disease-free survival were 89.0% and 81.6%, respectively. Significant risk factors for recurrence were age <18 years (p=0.0087) and parenchyma-preserving surgical approaches (p=0.0006). The postoperative long-term outcome showed ECOG=0-1 in all patients, with resection related exocrine insufficiency in 20 (41%) and diabetes mellitus in 2 (4%) patients. - Conclusions - Age<18 years is a significant risk factor for malignancy in SPN, and parenchyma preserving resections harbor a significant risk for tumor recurrence. As recurrence may occur late, a systematic life-long follow-up should be performed.