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Establishment and Characterization of Small Bowel Neuroendocrine Tumor Spheroids

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Potential Role for Observation in Small Solid Pseudopapillary Neoplasm (SPN).

Oliver Standring¹, Susana Benitez Sanchez¹, Shamsher Pasha²

¹Northwell Health, North Shore/Long Island Jewish General Surgery, Manhasset, NY, USA.

Annals of Surgical Oncology

|May 26, 2023

Summary

This summary is machine-generated.

Observation may be suitable for small, localized pancreatic solid pseudopapillary neoplasms (SPN). This study found no occult nodal metastasis in early-stage SPN, suggesting observation can mitigate resection risks.

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Area of Science:

Oncology
Surgical Oncology
Gastroenterology

Background:

Solid pseudopapillary neoplasms (SPN) are rare pancreatic tumors predominantly affecting young women.
Surgical resection is the standard treatment but carries significant risks.
This study investigates the safety of observing small, localized SPN.

Purpose of the Study:

To evaluate the feasibility of non-operative management for select SPN cases.
To determine the risk of occult nodal metastasis in early-stage SPN.
To identify criteria for safely observing SPN and avoiding unnecessary surgery.

Main Methods:

Retrospective review of the Pancreas National Cancer Database (2004-2018).
Identification of SPN using histology code 8452.
Analysis of clinical staging, surgical resection rates, and occult nodal metastasis.

Main Results:

994 SPNs were identified; 84.9% of patients were female, with a mean age of 36.8 years.
Resection was performed in 96.6% of patients.
No occult nodal metastasis was found in cT1 (0%) or cT2 (0.5%) SPN, but risk increased significantly for cT3 (8.9%) and cT4 (50%) disease.

Conclusions:

Clinical assessment accurately excludes nodal involvement in tumors ≤ 4 cm (99.5% specificity) and ≤ 2 cm (100% specificity).
Close observation may be a safe option for patients with cT1N0 SPN.
Observation can help reduce morbidity associated with major pancreatic resections.