Paredes Oscar, Paredes Kori, Kawaguchi Yoshikuni, Luque-Vasquez Carlos, Chavez Iván, Celis Juan, Payet Eduardo, Ruiz Eloy, Berrospi Francisco
Department of Abdominal Surgery, National Institute of Neoplastic Diseases INEN, Lima, Peru.
, Montesquieu Street 277, Lima, Perú.
Discov Oncol. 2021 Nov 22;12(1):53. doi: 10.1007/s12672-021-00451-4.
Solid pseudopapillary neoplasm (SPN) is an uncommon pathology with a low-grade malignancy. Surgery is the milestone treatment. Nevertheless, despite appropriate management, some patients present recurrence. Risk factors associated with recurrence are unclear. The objective was to identify the clinicopathological factors associated with recurrence in patients with SPN treated with pancreatic resection.
Medical records of patients treated with pancreatic resection during 2006-2020 were evaluated. Patients with histological diagnosis of SPN were included. Survival analysis was performed to identify the clinicopathological factors related to recurrence.
Seventy-four patients were diagnosed with SPN; 70 (94.6%) patients were female, and the median age was 20 years old. The median tumor diameter was 7.9 cm. Multivisceral resection was performed in 9 (12.2%) patients. Four (5.4%) patients presented lymph node metastasis.R0 resection was achieved in all cases. Six (8%) patients presented recurrence and the liver was the most frequent recurrence site (n = 5).After a median follow-up of 40.2 months, 9 (12%) patients died. Five (6.8%) patients died of disease progression. The 1-3- and 5-year overall survival (OS) was 97.1%, 90.2% and 79.9%, respectively. The 1-3-and-5-year recurrence-free survival (RFS) was 98.4%, 89.9% and 87%, respectively. In the univariate Cox-regression analysis, age ≥ 28 years(HR = 8.61, 95% CI 1.1-73.8),tumor diameter ≥ 10 cm(HR = 9.3, 95% CI 1.12-79.6),invasion of adjacent organs (HR = 7.45, 95% CI 1.5-36.9), lymph node metastasis (pN +) (HR = 16.8, 95% CI 2.96-94.9) and, AJCC Stage III (HR = 10.1, 95% CI 1.2-90.9) were identified as predictors for recurrence.
SPN is more frequently diagnosed in young women with a good overall prognosis after an R0 surgical resection even with disease recurrence. Age ≥ 28 years, larger tumors ≥ 10 cm, invasion of adjacent organs, lymph node metastasis(pN +) and, AJCC Stage III were predictors factors of recurrence in resected SPN.
实性假乳头状肿瘤（SPN）是一种罕见的低度恶性病变。手术是关键治疗手段。然而，尽管治疗得当，仍有部分患者出现复发。与复发相关的危险因素尚不清楚。本研究旨在确定接受胰腺切除术治疗的SPN患者中与复发相关的临床病理因素。
评估2006年至2020年期间接受胰腺切除术患者的病历。纳入经组织学诊断为SPN的患者。进行生存分析以确定与复发相关的临床病理因素。
74例患者被诊断为SPN；70例（94.6%）为女性，中位年龄为20岁。肿瘤中位直径为7.9 cm。9例（12.2%）患者接受了多脏器切除。4例（5.4%）患者出现淋巴结转移。所有病例均实现R0切除。6例（8%）患者出现复发，肝脏是最常见的复发部位（n = 5）。中位随访40.2个月后，9例（12%）患者死亡。5例（6.8%）患者死于疾病进展。1年、3年和5年总生存率（OS）分别为97.1%、90.2%和79.9%。1年、3年和5年无复发生存率（RFS）分别为98.4%、89.9%和87%。在单因素Cox回归分析中，年龄≥28岁（HR = 8.61，95%CI 1.1 - 73.8）、肿瘤直径≥10 cm（HR = 9.3，95%CI 1.12 - 79.6）、侵犯相邻器官（HR = 7.45，95%CI 1.5 - 36.9）、淋巴结转移（pN+）（HR = 16.8，95%CI 2.96 - 94.9）和美国癌症联合委员会（AJCC）III期（HR = 10.1，95%CI 1.2 - 90.9）被确定为复发的预测因素。
SPN在年轻女性中更常见，即使疾病复发，R0手术切除后总体预后良好。年龄≥28岁、肿瘤≥10 cm、侵犯相邻器官、淋巴结转移（pN+）和AJCC III期是切除的SPN复发的预测因素。
