Organ-preserving surgery and classic surgery for pancreatic solid pseudopapillary neoplasms:a multicenter analysis from Central and Western China

Background:Pancreatic solid pseudopapillary neoplasms(SPNs)are low-grade malignant tumors of the pancreas.Organ-pre-serving surgery is being increasingly performed for these tumors,although there is little evidence to support its use.This retro-spective multicenter study aimed to determine the clinicopathologic characteristics of pancreatic SPNs in Central and Western China and to determine the efficacy of organ-preserving surgery.Methods:The clinicopathologic,treatment and follow-up data of 227 pancreatic SPN patients treated between July 2003 and December 2016 at 5 tertiary care centers were retrospectively reviewed.Results:Among the 227 patients(38 males,189 females;mean age 33.30±12.70 years),only 72(31.7%)had symptoms.The mean tumor size was 55.08±29.56 mm.Adjacent organ/lymphovascular invasion was present in 16(7.1%)patients and distant metastasis in 3(1.3%)patients;no patient had spread to distant lymph nodes.Surgery included organ-preserving surgery in 108(47.6%)patients,classic surgery in 115(50.7%)patients,and palliative surgery in 4(1.8%)patients.Tumor recurrence was seen in 8(3.6%)patients.Cox regression analysis showed positive surgical margin(P<.01)and metastasis(P=.03)to be independent predictors of recurrence.Tumor characteristics were comparable between patients receiving organ-preserving surgery and classic surgery.The risk of recurrence was also similar in both groups(P=.72).Conclusions:Organ-preserving surgery appears to be an effective procedure for the treatment of pancreatic SPNs.Resection surgery should aim for negative surgical margins.