Prognostic value of Ki-67 in solid pseudopapillary tumor of the pancreas: Huashan experience and systematic review of the literature

Yang, Feng; Yu, Xinzhe; Bao, Yun; Du, Zunguo; Jin, Chen; Fu, Deliang

doi:10.1016/j.surg.2015.10.018

Cited by 70 publications

(87 citation statements)

References 39 publications

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“…Yang et al [25] found that a Ki-67 ≥ 4% was significantly associated ( p < 0.001) with recurrence. In our experience neither high Mib 1 nor Ki-67 ≥ 4% was associated with clinical or histopathological features of malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…Our experience confirms that, at present, there are no established clinical or histological criteria to predict the biological behaviour of SPT. While invasion of blood vessels, perineural infiltration, invasion of adjacent structures, and elevated mitotic rate are suggested to be associated with metastases and recurrence in some reports [25, 28, 29], they appear to be not related to prognosis in other experience [30], and the absence of these features does not preclude malignant behaviour [22], so long-term follow-up is warranted in all patients [31]. …”

Section: Discussionmentioning

confidence: 99%

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Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Beltrame

Pozza

Bona

et al. 2016

Gastroenterology Research and Practice

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Aim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers (CEA and CA 19-9) determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor (n = 2), mucinous tumor (n = 2), and SPT (n = 14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection (n = 1) or liver metastases (n = 1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36–228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Beltrame

Pozza

Bona

et al. 2016

Gastroenterology Research and Practice

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“…Demographic and clinicopathological data of the SPTP patients were obtained via the Hospital Physician Electronic Workstation . The clinicopathological characteristics of some of the patients have been reported in our previous studies . The definition of malignant SPTP adopted in this study has been reported in a previous study .…”

Section: Methodsmentioning

confidence: 99%

“…Comparisons of variables between groups were performed using the χ 2 test, the Mann‐Whitney U test, or independent‐samples t test. The optimal cut‐off values of continuous variables including NLR and PLR for predicting malignant SPTP were determined by using receiver operating characteristic (ROC) curve analysis and applying the Youden index (ie sensitivity + specificity −1) . Associations between variables and malignant SPTP were assessed using logistic regression analysis.…”

Section: Methodsmentioning

confidence: 99%

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Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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Background Systemic inflammatory markers such as neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have been shown to be prognostic for many types of pancreatic malignancy. The aim of this study was to evaluate the prognostic role of these markers in patients with solid pseudopapillary tumor of the pancreas (SPTP). Methods Patients who underwent surgical resection for histologically confirmed SPTP were retrospectively reviewed in our institution. Preoperative NLR and PLR were calculated. Clinicopathologic data were correlated with the presence of malignant potential and recurrence‐free survival (RFS). Results A total of 113 patients with SPTP were included in this study. Of them, 23 were men and 90 were women, with a median age of 35 years (interquartile range, 25‐44). The optimal cut‐off values for malignant SPTP were 3.22 for NLR, and 75.5 for PLR, respectively. Univariate analysis showed that high NLR (>3.22) and white blood cell count more than 9.96 × 109/L were predictive of a malignant SPTP. Meanwhile, high NLR (P = 0.001) and age more than 35 years (P = 0.026) were associated with worse RFS. On multivariable analyses, high NLR was the only independent predictor of malignant SPTP (odd ratio 6.871; 95% confidence interval [CI], 1.482‐31.864; P = 0.014) and RFS (hazard ratio 12.633; 95% CI, 1.758‐90.790; P = 0.012). Conclusions This study highlights the supportive role of preoperative NLR in predicting malignancy and RFS of SPTP patients. Further studies including a larger cohort of patients are needed to corroborate our findings.

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Clinical significance of drain fluid culture after pancreaticoduodenectomy

Yang

Jin

et al. 2018

J Hepato Biliary Pancreat

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Background The mechanism of infected postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy (PD) is undefined. Drain amylase has been used to predict POPF, whereas little data are available about the value of drain fluid culture. The aim was to investigate the incidence, risk factors and association with surgical outcomes of positive drainage culture (PDC) after PD. Methods A single‐center retrospective analysis was conducted of prospectively collected data from patients who underwent PD between January 2005 and December 2015. Drain fluid samples were obtained for microbiological analysis after surgery. Risk factors for PDC were evaluated, and its influence on surgical outcomes was explored. Results Of 768 patients, 261 (34%) had PDC during the postoperative period. Among them, a total of 434 isolates were yielded. One hundred and seven (24.7%) were Gram‐positive, 283 (65.2%) Gram‐negative, and 44 (10.1%) fungi. Multivariate analysis revealed that body mass index (BMI) ≥25 kg/m2, preoperative chemoradiation and intra‐operative red blood cell transfusion were independent risk factors for PDC. PDC was associated with higher incidences of complications including POPF, major complications and reoperation, but with no correlation between the day of PDC and complications. BMI ≥25 kg/m2, early PDC (≤3 days), main pancreatic duct <3 mm, and soft pancreas were revealed as independent predictors for POPF. There was a correlation between type of microorganisms and complications. Conclusion Considering the correlation between PDC and postoperative complications, preventive measures are crucial to improve outcomes after PD. Whether antibiotic treatment for early PDC will alter the clinical course of POPF needs further evaluation.

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Prognostic value of Ki-67 in solid pseudopapillary tumor of the pancreas: Huashan experience and systematic review of the literature

Cited by 70 publications

References 39 publications

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Clinical significance of drain fluid culture after pancreaticoduodenectomy

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