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Updated: Jan 15, 2026
Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Contemporary Analysis of Solid Pseudopapillary Neoplasms in Children Versus Adults
Ioannis A Ziogas1, Kristine S Corkum2, Andrii Khomiak3
1Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado; Surgical Oncology Program, Children's Hospital Colorado, Aurora, Colorado; Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
Insights
Children with solid pseudopapillary neoplasm (SPN) have significantly better survival rates than adults, despite similar disease presentation. Surgery is the primary treatment for both groups, but children receive chemotherapy less often.
Area of Science:
- Oncology
- Pediatric Oncology
- Surgical Oncology
Background:
- Solid pseudopapillary neoplasm (SPN) represents a rare but distinct group of pancreatic tumors, accounting for approximately 2% of all pancreatic neoplasms.
- Understanding the clinical nuances, management strategies, and long-term outcomes of SPN is crucial for optimizing patient care, particularly when comparing pediatric and adult populations.
Purpose of the Study:
- To investigate and compare the clinical characteristics, treatment modalities, and survival outcomes of solid pseudopapillary neoplasm (SPN) in pediatric versus adult patients.
- To identify prognostic factors influencing mortality risk in patients diagnosed with SPN.
Main Methods:
- Retrospective analysis of the National Cancer Database (NCDB) from 2004 to 2020.
- Inclusion criteria comprised patients diagnosed with SPN, stratified into pediatric (<18 years) and adult (≥18 years) cohorts.
- Statistical analyses included comparisons of demographics, tumor characteristics, treatment received, and survival rates, utilizing multivariable Cox regression for prognostic factor identification.
Main Results:
- A total of 1325 SPN cases were analyzed (231 children, 1094 adults), with no significant differences in tumor size, metastasis, or stage at presentation between the groups.
- Surgical resection was the predominant treatment in both pediatric (96.5%) and adult (92.1%) cohorts; however, chemotherapy use was significantly lower in children (0.9% vs. 4.2%).
- The 10-year overall survival rate was markedly higher in children (99.1%) compared to adults (88.0%). Adulthood, higher Charlson-Deyo score, advanced tumor stage (II-IV), and receipt of chemotherapy/radiation were associated with increased mortality risk, while Hispanic ethnicity and surgical treatment correlated with decreased mortality.
Conclusions:
- Children with solid pseudopapillary neoplasm (SPN) demonstrate superior long-term survival outcomes compared to adults, even when diagnosed at similar disease stages.
- While surgical intervention is standard for both age groups, the lower utilization of chemotherapy in pediatric SPN warrants further investigation.
- Adulthood and advanced disease stage are significant predictors of mortality in SPN patients.
Introduction:
Solid pseudopapillary neoplasm (SPN) comprises 2% of pancreatic tumors. We aimed to examine the clinical characteristics, management, and outcomes of SPN in children and adults using US-based national cancer registry data.
Methods:
In this retrospective National Cancer Database analysis, children (<18 y) and adults (≥18 y) with SPN were included (2004-2020).
Results:
A total of 1325 patients (231 children, 1094 adults) with SPN were identified. There were no differences between groups regarding tumor size, metastasis, or stage. Most patients in both groups underwent surgical treatment (96.5% versus 92.1%, P = 0.056), whereas a smaller proportion of children received chemotherapy compared to adults (0.9% versus 4.2%, P = 0.01). The 10-year overall survival rate was 99.1% in children versus 88.0% in adults. In multivariable Cox regression, when adjusted for tumor location and receipt of chemotherapy and radiation, adulthood (hazard ratio [HR]: 5.32, 95% confidence interval [95% CI]: 1.26-22.49, P = 0.02), Charlson-Deyo score ≥2 (HR: 3.04, 95% CI: 1.21-7.63, P = 0.02) compared to 0, stage II (HR: 2.48, 95% CI: 1.27-4.82, P = 0.008), stage III (HR: 6.82, 95% CI: 1.50-31.02, P = 0.01), and stage IV (HR: 5.94, 95% CI: 2.49-14.16, P < 0.001) compared to stage I were associated with an increased risk of mortality, whereas Hispanic compared to White patients (HR: 0.44, 95% CI: 0.21-0.95, P = 0.04) and surgically treated patients had a decreased risk of mortality (HR: 0.10, 95% CI: 0.05-0.21, P < 0.001).
Conclusions:
Despite similar stage presentation, children with SPN exhibit prolonged survival compared to adults. Most patients underwent surgical treatment, whereas children were less likely to undergo chemotherapy than adults.
