Department of Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama.
Department of Surgery, University of Alabama at Birmingham, Children's of Alabama, Birmingham, Alabama.
J Surg Res. 2019 Oct;242:312-317. doi: 10.1016/j.jss.2019.04.070. Epub 2019 May 23.
Solid pseudopapillary neoplasms (SPPNs) comprise the majority of pediatric pancreatic neoplasms. We queried the National Cancer Database to compare pediatric and adult patients with SSPNs to examine differences in demographics, tumor characteristics, treatment, and overall survival. We aimed to determine if survival differences existed between adult and pediatric patients with SPPN.
The National Cancer Database (2004-2014) was reviewed, and patients were stratified by age at diagnosis: pediatric (≤21 y) and adult (≥22 y). Demographics, comorbidities, tumor characteristics, diagnostic periods, treatments, and survival rates were compared using pooled variance t-tests and chi-square, followed by multivariate Cox proportional hazard model (α = 0.05). Log-rank test was used to compare survival.
A total of 468 patients were analyzed and categorized according to age group. Four hundred and fourteen patients were included in the survival analysis. The pediatric patients were primarily female, Caucasian, had no comorbidities, and presented with stage I disease. Race/ethnicity, gender, socioeconomic status, comorbidities, and disease stage at presentation were similar between the groups. There was no difference in time to initiation of therapy or to surgical intervention. No significant difference was found in type of surgical resection, chemotherapy, or radiotherapy utilization. Despite the similarities between groups, comparison of overall survival demonstrated improved survival of pediatric SPPN compared with adult SPPN in every pathologic stage.
These results suggest that pediatric and adult SPPNs are similar with regards to demographics, tumor characteristics, and treatment modalities. However, survival was better in children with SPPNs, which may be due to differences in tumor biology and may serve for risk stratification of prognosis.
实性假乳头状肿瘤（SPPN）构成了大多数儿科胰腺肿瘤。我们查询了国家癌症数据库，以比较儿童和成人 SPPN 患者，以检查人口统计学、肿瘤特征、治疗和总体生存率的差异。我们旨在确定 SPPN 儿童和成人患者的生存是否存在差异。
回顾了国家癌症数据库（2004-2014 年），并根据诊断时的年龄将患者分层：儿童（≤21 岁）和成人（≥22 岁）。使用汇总方差 t 检验和卡方比较人口统计学、合并症、肿瘤特征、诊断期、治疗和生存率，然后进行多变量 Cox 比例风险模型（α=0.05）。对数秩检验用于比较生存。
共分析了 468 例患者，并根据年龄组进行分类。414 例患者纳入生存分析。儿科患者主要为女性、白种人、无合并症，且表现为 I 期疾病。种族/民族、性别、社会经济地位、合并症和疾病分期在两组之间相似。治疗开始时间或手术干预时间无差异。手术切除、化疗或放疗的类型无显著差异。尽管两组之间存在相似性，但总体生存率的比较表明，儿科 SPPN 的生存优于成人 SPPN，在每个病理分期均如此。
这些结果表明，儿科和成人 SPPN 在人口统计学、肿瘤特征和治疗方式方面相似。然而，儿童 SPPN 的生存更好，这可能是由于肿瘤生物学的差异，并可能用于预后风险分层。
