Solid pseudopapillary neoplasm of the pancreas: National Cancer Data Base analysis of a gender-specific carcinoma with good prognosis

Xuefei Wang, Nicholas Sich, Jiping Wang, Lianne Heuthorst, Christopher Pezzi


Background: Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor which predominantly occurs in young female. This research analyzes characteristics and outcomes of this disease by gender.
Methods: Patients diagnosed with SPN between 1998 and 2012 were identified from the National Cancer Data Base (NCDB) (n=389). Characteristics and treatment outcomes were compared between genders.
Results: SPN diagnoses has continued to increase during the last 15 years, a majority of which were female (324/389, 83.3%). Males are diagnosed significantly later than females (50.1 vs. 38.4 years, P<0.0001); are more likely to have metastasis (14.5% vs. 5.6%, P=0.03); less likely to undergo resection (72.3% vs. 90.4%, P<0.0001); and more likely to receive chemotherapy (19.0% vs. 8.7%, P=0.01). Forty-nine patients who did not undergo surgery had a significantly worse survival compared to those who did (5-year survival: 49.7% vs. 95.0%, P<0.001). Among these, males had worse survival than females (median survival: 37.4 vs. 60.5 months, P=0.33). For surgical patients, there is no survival difference between sex groups (5-year survival: 94.0% vs. 95.2%, P=0.86).
Conclusions: Patients with SPN should undergo surgical resection due to the significant survival advantage seen. Further study is needed to confirm the observed survival difference between males and females with unresectable disease.