Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2021; 13(6): 589-599
Published online Jun 15, 2021. doi: 10.4251/wjgo.v13.i6.589
Yield of surgery in solid pseudopapillary neoplasms of the pancreas: A case series and literature review
Flávio Silano, Ricardo Bandeira de Melo Amaral, Rodolfo Carvalho Santana, Vanessa Costa Neves, José Celso Ardengh, Paulo Cezar Galvão do Amaral
Flávio Silano, Digestive Surgery, Hospital São Rafael/Rede D’Or, Salvador 40285000, Bahia, Brazil
Ricardo Bandeira de Melo Amaral, Rodolfo Carvalho Santana, Vanessa Costa Neves, Paulo Cezar Galvão do Amaral, Department of Surgery of the Upper Digestive System, São Rafael Hospital/Rede D’Or Hospital Group, Salvador 41253-190, Bahia, Brazil
José Celso Ardengh, Surgery and Anatomy, Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo, São Paulo 04611-000, São Paulo, Brazil
José Celso Ardengh, Endoscopy Service, Hospital 9 de Julho, São Paulo 04611-000, São Paulo, Brazil
José Celso Ardengh, Imaging and Diagnosis, Escola Paulista de Medicina - São Paulo Federal University, São Paulo 04611-000, SP, Brazil
Author contributions: All authors contributed to review and writing the manuscript equally; Silano F, de Melo Amaral RB, Santana RC, Neves VC, Ardengh JC, do Amaral PCG all approved the final version.
Institutional review board statement: Approval Obtained from Institutional Reivew Board of “Hospital São Rafael/Rede D’Or Ethics and Research Committee; Approval No. 35555820.0.0000.0048; Approval Date: 28/07/2020.”
Informed consent statement: This is not applicable. The authors’ own database was used. There is no clinical trial, there is no drug test, and there is no exposure of patients.
Conflict-of-interest statement: None of the Authors has any conflict of interest related to the manuscript.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Flávio Silano, MD, Medical Assistant, Surgeon, Surgical Oncologist, Digestive Surgery, Hospital São Rafael/Rede D’Or, Av São Rafael 2152, São Marcos, Salvador 40285000, Bahia, Brazil.
Received: November 3, 2020
Peer-review started: November 3, 2020
First decision: January 29, 2021
Revised: March 24, 2021
Accepted: May 7, 2021
Article in press: May 7, 2021
Published online: June 15, 2021
Research background

Study with 14 patients, operated in a single center, regardless of the size of the tumor, obtained Margins R0, disease-free survival in 100% of cases, with a follow-up longer than 5 years.

Research motivation

Surgical treatment is the main pillar of cure for solid papillary neoplasm of the pancreas. The challenge is to improve access to imaging exams, screening programs and surgeons specialized in pancreatic surgery. The importance is in early diagnosis, greater chance of R0 surgery with less resection of other structures and consequently greater survival.

Research objectives

Show that solid pseudopapillary neoplasms, even when in large volumes and with the need to dry other noble structures, such as large vessels, has the possibility of cure in surgery. We were able to demonstrate in this study, with R0 surgeries and evidencing deonca-free survival and quality of life.

Research methods

Retrospective study with analysis of a prospectively filled database.

Research results

This study was made up of female patients in its entirety, corroborating the literature on being a more frequent neoplasm in women. Approximately 85% asymptomatic, incidental discovery. In our series, we have seen an increase in cases since 2012. Perhaps due to greater accessibility to imaging methods. The fact that women have specific programs for women’s health with periodic examinations and screening, may contribute to the discovery of tumors such as Solid papillary neoplasm of the pancreas in asymptomatic patients, and that we are facing an underreported neoplasm, but it is evident that we need more studies to affirm this.

Research conclusions

One theory would be that of an underdiagnosed neoplasm.

Research perspectives

Follow-up of operated patients to assess the natural history of the disease.