The clinicopathological characteristies of the patients with solid pseudopapillary tumor of the pancreas

INTRODUCTION: In this study we aimed to evaluate the follow up and treatment modalities along with the results of the patients with pancreatic pseudopapillary tumors (SPT)
METHODS: We evaluated the clinical and pathological parameters, treatments and long-term follow-up results of 12 patients diagnosed with SPT between 2005 and 2016 in our clinic.
RESULTS: Two thirds of patients were female and median age was 39.5 years (range 19-71). Pancreatic tail (%53.8) was the most common site for tumor localization. Distal pancreatectomy (n=7), Whipple surgery (n=4) and total pancreatectomy (n=1) were the surgical procedures. Mean tumor diameter was 8.4 cm (range= 4-15 cm). We identified perineural invasion (PNI) in 3 patients and lymphovascular invasion (LVI) in 2 patients. Three patients received adjuvant radiotherapy following 6 cycles of adjuvant chemotherapy since they were considered as malign SPT. Two of them received 6 cycles of gemcitabine whereas the other one was 6 cycles of capecitabine as adjuvant chemotherapy. Median overall and disease-free survival were not reached. Only 3 (25%) patients relapsed at a median follow-up of 25.1 months (range= 1.9-84.1).
DISCUSSION AND CONCLUSION: We consider that nodal involvement, LVI, PNI, advanced age and male gender might be poor prognostic factors in SPT. Ajuvant chemotherapy and/or radiotherapy might be considered for these patients. However, we need prospective clinical trials to determine poor risk factors and the treatment modalities for the patients with poor prognistic factors.

Pankreasýn solid psödopapiller tümörlü hastalarýn klinikopatolojik özellikleri

GÝRÝÞ ve AMAÇ: Bu çalýþmada kliniðimizdeki pankreas solid psödopapiller tümörlü (SPT) hastalarýn klinik verileri eþliðinde tedavi ve takip uygulamalarý ile bunlarýn sonuçlarý tartýþýlmýþtýr.
YÖNTEM ve GEREÇLER: Eylül 2005- Ocak 2016 yýllarý arasýnda kliniðimizde SPT tanýsý alan 12 hastanýn klinik ve patolojik parametreler, aldýklarý tedaviler ve uzun süreli takip sonuçlarý açýsýndan deðerlendirildi.
BULGULAR: Hastalarýn 2/3’ü kadýn ve median yaþ 39.5 (aralýk 19-71) idi. Primer tümörün en sýk yerleþim yeri (58.3%) pankreas kuyruk kesimi idi. Cerrahi tedavi olarak 7 hastaya distal pankreotektomi, 4 hastaya Whipple, 1 hastaya ise total pankreatektomi uygulanmýþtý. Ortalama tümör boyutu 8.4 cm (4-15) olarak saptandý. 3 hastada perinöral invazyon (PNI) ve 2 hastada lenfovasküler invazyon (LVI) saptandý. Üç hasta malign SPT olarak duþunuldu ve bu hastalardan birine adjuvan kapesitabin kemoterapisi sonrasý adjuvan radyoterapi verildi. Geriye kalan iki hastaya ise adjuvan gemsitabin kemoterapisi verildi. Medyan genel ve hastalýksýz saðkalýma ulaþýlamadý. Medyan takip süresi 25.1 ay (1.9-84.1 ay) idi ve takiplerde 3 (25%) hastada nüks meydana geldi.
TARTIÞMA ve SONUÇ: Pankreasýn SPT'inde lenf nodu tutulumu, LVI, PNI, ileri yaþ ve erkek cinsiyet kötü prognostik faktörler olabilir. Bu hastalarda kemoterapi ve/veya radyoterapi düþünülebilir. Ancak SPT'de kötü risk faktörlerinin belirlenmesi ve kötü risk grubundaki hastalarda adjuvan tedavinin yerini belirleyebilmek için prospektif klinik çalýþmalara ihtiyaç vardýr.