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Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution.

Publication ,  Journal Article
Estrella, JS; Li, L; Rashid, A; Wang, H; Katz, MH; Fleming, JB; Abbruzzese, JL; Wang, H
Published in: Am J Surg Pathol
February 2014

Although solid pseudopapillary neoplasms (SPNs) are considered tumors of low malignant potential, patients may present with aggressive disease (ie, liver metastasis/invasion into adjacent organs) and, rarely, die from disease. Although the clinicopathologic features associated with aggressive SPNs have been reported, important prognostic factors of survival remain unclear. We systematically reviewed 64 cases of SPN resected at our institution for tumor size, extent of invasion, margin status, presence of lymphovascular, muscular vessel, and perineural invasion, and lymph node and distant metastases. Clinicopathologic characteristics were correlated with the presence of metastasis/recurrence and disease-specific survival. Five (8%) patients presented with stage IV disease. During follow-up, 5 (13%) of 39 patients with stage I-II disease had recurrences. Patients with metastatic/recurrent SPNs had significantly larger tumor size (P<0.001) and more frequent tumor invasion into muscular vessels (P=0.02). In a median follow-up of 76 months, only 2 died of disease (1 who presented with extensive peritoneal tumor involvement who died 2.5 mo after surgery, and 1 unusual case who presented with multiple liver metastasis and peritoneal seeding who died 19 mo after surgery), and 5 were alive with disease. The 10-year disease-specific survival rate was 96%. Muscular vessel invasion (P=0.001), tumor (T) stage by European Neuroendocrine Tumors Society (ENETS) classification (P<0.001), ENETS stage grouping (P<0.001), and stage grouping by the American Joint Committee on Cancer (AJCC stage, P<0.001) were important predictors of disease-specific survival in patients with SPN. Our study highlights the importance of pathologic evaluation in risk assessment in patients with SPNs.

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Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

February 2014

Volume

38

Issue

2

Start / End Page

147 / 157

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Texas
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Pathology
  • Pancreaticoduodenectomy
 

Citation

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Estrella, J. S., Li, L., Rashid, A., Wang, H., Katz, M. H., Fleming, J. B., & Abbruzzese, J. L. (2014). Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution. Am J Surg Pathol, 38(2), 147–157. https://doi.org/10.1097/PAS.0000000000000141
Estrella, Jeannelyn S., Lei Li, Asif Rashid, Hua Wang, Matthew H. Katz, Jason B. Fleming, James L. Abbruzzese, and Huamin Wang. “Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution.Am J Surg Pathol 38, no. 2 (February 2014): 147–57. https://doi.org/10.1097/PAS.0000000000000141.
Estrella JS, Li L, Rashid A, Wang H, Katz MH, Fleming JB, et al. Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution. Am J Surg Pathol. 2014 Feb;38(2):147–57.
Estrella, Jeannelyn S., et al. “Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution.Am J Surg Pathol, vol. 38, no. 2, Feb. 2014, pp. 147–57. Pubmed, doi:10.1097/PAS.0000000000000141.
Estrella JS, Li L, Rashid A, Wang H, Katz MH, Fleming JB, Abbruzzese JL. Solid pseudopapillary neoplasm of the pancreas: clinicopathologic and survival analyses of 64 cases from a single institution. Am J Surg Pathol. 2014 Feb;38(2):147–157.

Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

February 2014

Volume

38

Issue

2

Start / End Page

147 / 157

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Texas
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Pathology
  • Pancreaticoduodenectomy