The optimal surgical approach for solid pseudopapillary neoplasm of the pancreas: A retrospective study

Abstract

The most effective surgical approach for solid pseudopapillary neoplasms (SPNs) remains unclear. We conducted a retrospective study of 14 patients diagnosed with SPN between September 2013 and October 2021. Thirteen patients were female, and the median age was 39.5 (18–63) years. The mean tumour diameter was 5.2 ± 2.2 (range, 2–10) cm. The type of surgery was decided based on the tumour location and the extrapancreatic invasion status. The conservative (organ-preserving) surgical procedure was spleen-preserving distal pancreatectomy (n=3). The radical surgical procedures included pancreaticoduodenectomy, with either venous reconstruction (n=2) or without (n=4), and distal pancreatectomy + splenectomy (n=5); similar to performed for pancreatic cancer regional lymphadenectomy was not performed. Tumour resection margins were free in all patients. There were no cases of lymph node metastasis, but the number of examined lymph nodes was significantly higher in the radical surgery group (p=0.03). A female patient developed multiple liver metastases one year after distal pancreatectomy + splenectomy. Her number of examined lymph nodes was the highest of the cohort (n=24). The mean follow-up time was 40 ± 23.5 months. All patients were alive at the end of the study. In conclusıon; necessity for radical surgery may be associated with malignant behaviour. Therefore, the extent of the surgical operation may be expanded during radical procedures for SPNs.

Keywords

• conservative surgery
• optimal surgical approach
• radical surgery
• solid pseudopapillary neoplasm

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