Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

The aim of this study was to determine the clinicopathological features, surgical management, and prognosis of solid pseudopapillary neoplasms (SPNs) of the pancreas. This study conducted a retrospective analysis of 97 patients who underwent surgery for a pathologically confirmed SPN in five hospitals between January 1996 and December 2014. The 97 cases included 93 female and 4 male patients, and the average age was 31.2 years. The tumor was located in the body or tail (70.1 %), the head (20.6 %), and the neck (9.3 %). All patients underwent surgical exploration, including distal pancreatectomy (63.9 %), pancreaticoduodenectomy (20.6 %) (partial portal vein or superior mesenteric vein resection and artificial vascular graft reconstruction performed in 4.1 % of the patients), central pancreatectomy (10.3 %), enucleation (5.2 %), and liver resection (1.0 %). 16.5 % of the patients had malignant tumors. The positive rate of Ki-67 was 66.7 % in patients diagnosed with a malignant neoplasm and was comparable to 8.4 % of the patients diagnosed to have a benign neoplasm (p < 0.001). After a median follow-up of 70.1 months, three patients had recurrence and one patient died of liver metastasis. SPN is a rare neoplasm with low malignant potential. Surgical resection is warranted even in the presence of local invasion or metastases as patients demonstrate excellent long-term survival. Positive immunoreactivity for Ki-67 may predict the malignant potential and poor outcome of SPNs.