Necessity of lymph node dissection in solid pseudopapillary tumor of the pancreas: A retrospective analysis.

Abstract

Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. The clinical relevance of lymph node dissection during surgical resection remains controversial due to limited evidence. We retrospectively reviewed the clinical records of patients with solid pseudopapillary tumor of the pancreas who underwent surgery at Shandong Provincial Hospital between 2005 and 2024. Lymph node status and clinicopathologic characteristics were analyzed. The patients were divided into 2 groups according to whether the lymph nodes were cleared or not, and the association between lymph node dissection and postoperative outcomes was evaluated. A total of 351 patients were included, with a male to female ratio of 63:288. Among 109 patients who underwent lymph node dissection, no lymph node metastasis was identified. Tumor location, age at diagnosis, and clinical presentation did not differ between sexes; however, female patients had significantly larger tumors than male patients (5.74 ± 3.46 cm vs 4.57 ± 2.82 cm, P = .013). A total of 182 patients were followed up after surgery, with a 41-month median follow-up time, including 60 patients with lymph node dissection and 122 patients without lymph node dissection. No tumor recurrence or metastasis occurred in either group, and the complication rates were comparable. In the absence of radiologic or intraoperative suspicion of nodal involvement, routine lymph node dissection may be unnecessary in solid pseudopapillary tumor of the pancreas surgery.