Aggressiveness of solid pseudopapillary neoplasm of the pancreas

Emmanuel Ii Uy Hao, Ho Kyung Hwang, Dong Sub Yoon, Woo Jung Lee, Chang Moo Kang

Research output: Contribution to journalReview articlepeer-review

27 Citations (Scopus)


Background: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors considered to be benign although 10% to 15% of SPNs have been reported to be aggressive. Due to its rarity, there have only been a few cases reported regarding the clinical course of patients with aggressive SPNs. The goal of this study is to describe the clinical course of patients diagnosed with aggressive SPNs. Methods: A PubMed search was done looking for articles describing the clinical course of patients diagnosed with SPN that locally invaded, recurred, or metastasized. Institutional experience was also added to the pooled data. Patient information was extracted from the articles. Survival and recurrence curves were plotted and factors associated with survival and recurrences were analyzed. Results: A total of 59 patients were identified to have aggressive SPN. Seven patients were males and 52 were females and the mean age was 37.44±2.21 years. Systemic metastasis constituted 81.4% while recurrence and deep tissue invasion were found in 11.9% and 6.8% of the patients, respectively. Disease-free survival was 45±6.28 months and disease-specific survival was 152.67 ±12.8 months. In survival analysis, age, gender, tumor size, tumor location, combined resection, type of recurrence, and stage IV on diagnosis were not significant factors in predicting survival. However, an unresectable tumor (hazards ratio [HR]=4.871, 95% confidence interval [CI] 1.480-16.03, P=.009), and metastasis within 36 months (HR=6.399, 95% CI: 1.390-29.452, P=.017) were identified as independent variables in predicting survival. Conclusion: SPNs of the pancreas carry a favorable course. Despite having aggressive properties, patients can still survive for more than 10 years as long as the tumor can be resected completely.

Original languageEnglish
Article numbere13147
JournalMedicine (United States)
Issue number49
Publication statusPublished - 2018 Dec 1

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© 2018 the Author(s).

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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