Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis
Background Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments. Methods Databases from three sources were screened for patients wit...
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| Veröffentlicht in: | World journal of surgery 2022-12, Vol.46 (12), p.3072-3080 |
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| creator | Lin, Young-Jen Burkhart, Richard Lu, Tzu-Pin Wolfgang, Christopher Wright, Michael Zheng, Lei Wu, Han-Yu Chen, Ching-Hsuan Lee, Shin-Yi Wu, Chien-Hui He, Jin Tien, Yu-Wen |
| description | Background
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments.
Methods
Databases from three sources were screened for patients with SPNs. We compared the perioperative variables, clinical data, overall survival (OS), and prognostic factors for recurrence among the three corresponding cohorts.
Results
We identified 286 patients diagnosed with SPNs between 1988 and 2020. Patients were mostly women (81%; median age: 38 years), and peak incidence was observed in women of 20–29 years of age. SPNs had a peak incidence in Asian men at 50–59 years of age (
p
= 0.002) and a delayed peak incidence in Asian women at 30–39 years of age (
p
|
| doi_str_mv | 10.1007/s00268-022-06717-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2710969210</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2731919845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4263-107b46edf5c4960d18f471e5961540d951f3e069becc77beff589e8d445a74143</originalsourceid><addsrcrecordid>eNqNkc1u1TAQhS0EopfCC7BAltiwCfgvdsyuvaUFVEFFQSwtJ5m0rpI4eBJV9-3xbQpILBDejDX6zvh4DiHPOXvNGTNvkDGhq4IJUTBtuCnUA7LhSopCSCEfkg2TWuU7lwfkCeINY9xoph-TA5lLPnJD8DL2oaUXCEsbJz-FvvdpRz9BnHqPA9LY0fka6IUfmwQe6VGTIiL94htAegJDHHFOfgZ6EnDyKcwh92_DfE23ccgNX_c7ehZjfiPFqzFiwKfkUed7hGf39ZB8O333dfu-OP989mF7dF40SmhZcGZqpaHtykZZzVpedcpwKK3mpWKtLXkngWlbQ9MYU0PXlZWFqlWq9EblPRySV-vcKcUfC-DshoAN5B-OEBd0wnBmtRWcZfTlX-hNXNKY3WVKcsttpcpMiZW620GCzk0pDHlfjjO3j8StkbgcibuLxO1dvLgfvdQDtL8lvzLIwNsVuA097P5jpPv-8fL4NIfJ92K5ijHrxitIf4z_w9NPU5eoGA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2731919845</pqid></control><display><type>article</type><title>Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis</title><source>MEDLINE</source><source>Wiley Journals</source><source>Springer Online Journals</source><creator>Lin, Young-Jen ; Burkhart, Richard ; Lu, Tzu-Pin ; Wolfgang, Christopher ; Wright, Michael ; Zheng, Lei ; Wu, Han-Yu ; Chen, Ching-Hsuan ; Lee, Shin-Yi ; Wu, Chien-Hui ; He, Jin ; Tien, Yu-Wen</creator><creatorcontrib>Lin, Young-Jen ; Burkhart, Richard ; Lu, Tzu-Pin ; Wolfgang, Christopher ; Wright, Michael ; Zheng, Lei ; Wu, Han-Yu ; Chen, Ching-Hsuan ; Lee, Shin-Yi ; Wu, Chien-Hui ; He, Jin ; Tien, Yu-Wen</creatorcontrib><description>Background
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments.
Methods
Databases from three sources were screened for patients with SPNs. We compared the perioperative variables, clinical data, overall survival (OS), and prognostic factors for recurrence among the three corresponding cohorts.
Results
We identified 286 patients diagnosed with SPNs between 1988 and 2020. Patients were mostly women (81%; median age: 38 years), and peak incidence was observed in women of 20–29 years of age. SPNs had a peak incidence in Asian men at 50–59 years of age (
p
= 0.002) and a delayed peak incidence in Asian women at 30–39 years of age (
p
< 0.001). Treatment strategies differed significantly across the institutions and included variations in the number of harvested lymph nodes and rates of vascular resection. Lymph node positivity was the only predictor of postoperative recurrence (odds ratio, 2.2; 95% confidence interval, 1.38–2.99;
p
= 0.007). Higher rates of lymphovascular invasion (
p
= 0.02), perineural invasion (
p
< 0.001), and R1 margin involvement (
p
< 0.001), as seen in one institution, did not result in poorer long-term survival in terms of the overall (
p
= 0.43), SPN-specific (
p
= 0.69), and recurrence-free survivals (
p
= 0.067).
Conclusions
In contrast to previous findings that SPNs are prevalent in young women, a racial predilection for middle-aged Asian men and a delayed female peak incidence were noted. Parenchyma-preserving pancreatectomy may be an acceptable treatment. Non-radical surgery may be appropriate in patients with multiple comorbidities.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-022-06717-4</identifier><identifier>PMID: 36066663</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adult ; Age ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Cardiac Surgery ; Comorbidity ; Female ; General Surgery ; Humans ; Lymph nodes ; Male ; Malignancy ; Medical prognosis ; Medicine ; Medicine & Public Health ; Men ; Middle Aged ; Neoplasms ; Original Scientific Report ; Pancreas ; Pancreas - pathology ; Pancreas - surgery ; Pancreatectomy ; Pancreatic cancer ; Pancreatic Neoplasms - pathology ; Parenchyma ; Patients ; Prognosis ; Retrospective Studies ; Surgery ; Survival ; Thoracic Surgery ; Tumors ; Vascular Surgery ; Women</subject><ispartof>World journal of surgery, 2022-12, Vol.46 (12), p.3072-3080</ispartof><rights>The Author(s) under exclusive licence to Société Internationale de Chirurgie 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>2022. The Author(s) under exclusive licence to Société Internationale de Chirurgie.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4263-107b46edf5c4960d18f471e5961540d951f3e069becc77beff589e8d445a74143</citedby><cites>FETCH-LOGICAL-c4263-107b46edf5c4960d18f471e5961540d951f3e069becc77beff589e8d445a74143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-022-06717-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-022-06717-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,41493,42562,45579,45580,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36066663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lin, Young-Jen</creatorcontrib><creatorcontrib>Burkhart, Richard</creatorcontrib><creatorcontrib>Lu, Tzu-Pin</creatorcontrib><creatorcontrib>Wolfgang, Christopher</creatorcontrib><creatorcontrib>Wright, Michael</creatorcontrib><creatorcontrib>Zheng, Lei</creatorcontrib><creatorcontrib>Wu, Han-Yu</creatorcontrib><creatorcontrib>Chen, Ching-Hsuan</creatorcontrib><creatorcontrib>Lee, Shin-Yi</creatorcontrib><creatorcontrib>Wu, Chien-Hui</creatorcontrib><creatorcontrib>He, Jin</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><title>Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments.
Methods
Databases from three sources were screened for patients with SPNs. We compared the perioperative variables, clinical data, overall survival (OS), and prognostic factors for recurrence among the three corresponding cohorts.
Results
We identified 286 patients diagnosed with SPNs between 1988 and 2020. Patients were mostly women (81%; median age: 38 years), and peak incidence was observed in women of 20–29 years of age. SPNs had a peak incidence in Asian men at 50–59 years of age (
p
= 0.002) and a delayed peak incidence in Asian women at 30–39 years of age (
p
< 0.001). Treatment strategies differed significantly across the institutions and included variations in the number of harvested lymph nodes and rates of vascular resection. Lymph node positivity was the only predictor of postoperative recurrence (odds ratio, 2.2; 95% confidence interval, 1.38–2.99;
p
= 0.007). Higher rates of lymphovascular invasion (
p
= 0.02), perineural invasion (
p
< 0.001), and R1 margin involvement (
p
< 0.001), as seen in one institution, did not result in poorer long-term survival in terms of the overall (
p
= 0.43), SPN-specific (
p
= 0.69), and recurrence-free survivals (
p
= 0.067).
Conclusions
In contrast to previous findings that SPNs are prevalent in young women, a racial predilection for middle-aged Asian men and a delayed female peak incidence were noted. Parenchyma-preserving pancreatectomy may be an acceptable treatment. Non-radical surgery may be appropriate in patients with multiple comorbidities.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Age</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Cardiac Surgery</subject><subject>Comorbidity</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Lymph nodes</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Neoplasms</subject><subject>Original Scientific Report</subject><subject>Pancreas</subject><subject>Pancreas - pathology</subject><subject>Pancreas - surgery</subject><subject>Pancreatectomy</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Parenchyma</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival</subject><subject>Thoracic Surgery</subject><subject>Tumors</subject><subject>Vascular Surgery</subject><subject>Women</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1u1TAQhS0EopfCC7BAltiwCfgvdsyuvaUFVEFFQSwtJ5m0rpI4eBJV9-3xbQpILBDejDX6zvh4DiHPOXvNGTNvkDGhq4IJUTBtuCnUA7LhSopCSCEfkg2TWuU7lwfkCeINY9xoph-TA5lLPnJD8DL2oaUXCEsbJz-FvvdpRz9BnHqPA9LY0fka6IUfmwQe6VGTIiL94htAegJDHHFOfgZ6EnDyKcwh92_DfE23ccgNX_c7ehZjfiPFqzFiwKfkUed7hGf39ZB8O333dfu-OP989mF7dF40SmhZcGZqpaHtykZZzVpedcpwKK3mpWKtLXkngWlbQ9MYU0PXlZWFqlWq9EblPRySV-vcKcUfC-DshoAN5B-OEBd0wnBmtRWcZfTlX-hNXNKY3WVKcsttpcpMiZW620GCzk0pDHlfjjO3j8StkbgcibuLxO1dvLgfvdQDtL8lvzLIwNsVuA097P5jpPv-8fL4NIfJ92K5ijHrxitIf4z_w9NPU5eoGA</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Lin, Young-Jen</creator><creator>Burkhart, Richard</creator><creator>Lu, Tzu-Pin</creator><creator>Wolfgang, Christopher</creator><creator>Wright, Michael</creator><creator>Zheng, Lei</creator><creator>Wu, Han-Yu</creator><creator>Chen, Ching-Hsuan</creator><creator>Lee, Shin-Yi</creator><creator>Wu, Chien-Hui</creator><creator>He, Jin</creator><creator>Tien, Yu-Wen</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>202212</creationdate><title>Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis</title><author>Lin, Young-Jen ; Burkhart, Richard ; Lu, Tzu-Pin ; Wolfgang, Christopher ; Wright, Michael ; Zheng, Lei ; Wu, Han-Yu ; Chen, Ching-Hsuan ; Lee, Shin-Yi ; Wu, Chien-Hui ; He, Jin ; Tien, Yu-Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4263-107b46edf5c4960d18f471e5961540d951f3e069becc77beff589e8d445a74143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Age</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Cardiac Surgery</topic><topic>Comorbidity</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Lymph nodes</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Neoplasms</topic><topic>Original Scientific Report</topic><topic>Pancreas</topic><topic>Pancreas - pathology</topic><topic>Pancreas - surgery</topic><topic>Pancreatectomy</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Parenchyma</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Survival</topic><topic>Thoracic Surgery</topic><topic>Tumors</topic><topic>Vascular Surgery</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lin, Young-Jen</creatorcontrib><creatorcontrib>Burkhart, Richard</creatorcontrib><creatorcontrib>Lu, Tzu-Pin</creatorcontrib><creatorcontrib>Wolfgang, Christopher</creatorcontrib><creatorcontrib>Wright, Michael</creatorcontrib><creatorcontrib>Zheng, Lei</creatorcontrib><creatorcontrib>Wu, Han-Yu</creatorcontrib><creatorcontrib>Chen, Ching-Hsuan</creatorcontrib><creatorcontrib>Lee, Shin-Yi</creatorcontrib><creatorcontrib>Wu, Chien-Hui</creatorcontrib><creatorcontrib>He, Jin</creatorcontrib><creatorcontrib>Tien, Yu-Wen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lin, Young-Jen</au><au>Burkhart, Richard</au><au>Lu, Tzu-Pin</au><au>Wolfgang, Christopher</au><au>Wright, Michael</au><au>Zheng, Lei</au><au>Wu, Han-Yu</au><au>Chen, Ching-Hsuan</au><au>Lee, Shin-Yi</au><au>Wu, Chien-Hui</au><au>He, Jin</au><au>Tien, Yu-Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2022-12</date><risdate>2022</risdate><volume>46</volume><issue>12</issue><spage>3072</spage><epage>3080</epage><pages>3072-3080</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare with low-grade malignancy and unclarified clinicopathological features. This study aimed to examine their characteristics and re-evaluate current treatments.
Methods
Databases from three sources were screened for patients with SPNs. We compared the perioperative variables, clinical data, overall survival (OS), and prognostic factors for recurrence among the three corresponding cohorts.
Results
We identified 286 patients diagnosed with SPNs between 1988 and 2020. Patients were mostly women (81%; median age: 38 years), and peak incidence was observed in women of 20–29 years of age. SPNs had a peak incidence in Asian men at 50–59 years of age (
p
= 0.002) and a delayed peak incidence in Asian women at 30–39 years of age (
p
< 0.001). Treatment strategies differed significantly across the institutions and included variations in the number of harvested lymph nodes and rates of vascular resection. Lymph node positivity was the only predictor of postoperative recurrence (odds ratio, 2.2; 95% confidence interval, 1.38–2.99;
p
= 0.007). Higher rates of lymphovascular invasion (
p
= 0.02), perineural invasion (
p
< 0.001), and R1 margin involvement (
p
< 0.001), as seen in one institution, did not result in poorer long-term survival in terms of the overall (
p
= 0.43), SPN-specific (
p
= 0.69), and recurrence-free survivals (
p
= 0.067).
Conclusions
In contrast to previous findings that SPNs are prevalent in young women, a racial predilection for middle-aged Asian men and a delayed female peak incidence were noted. Parenchyma-preserving pancreatectomy may be an acceptable treatment. Non-radical surgery may be appropriate in patients with multiple comorbidities.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>36066663</pmid><doi>10.1007/s00268-022-06717-4</doi><tpages>9</tpages></addata></record> |
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| ispartof | World journal of surgery, 2022-12, Vol.46 (12), p.3072-3080 |
| issn | 0364-2313 1432-2323 |
| language | eng |
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| source | MEDLINE; Wiley Journals; Springer Online Journals |
| subjects | Abdominal Surgery Adult Age Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Cardiac Surgery Comorbidity Female General Surgery Humans Lymph nodes Male Malignancy Medical prognosis Medicine Medicine & Public Health Men Middle Aged Neoplasms Original Scientific Report Pancreas Pancreas - pathology Pancreas - surgery Pancreatectomy Pancreatic cancer Pancreatic Neoplasms - pathology Parenchyma Patients Prognosis Retrospective Studies Surgery Survival Thoracic Surgery Tumors Vascular Surgery Women |
| title | Solid Pseudopapillary Neoplasms of the Pancreas Across Races Demonstrate Disparities with Comparably Good Prognosis |
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