Risk factors of the recurrences of solid pseudopapillary neoplasms of the pancreas: meta-analysis / 中华肝胆外科杂志

ABSTRACT

Objective:To investigate the risk factors of postoperative recurrence of solid pseudopapillary neoplasms of the pancreas (SPN).Methods:Case-control studies on risk factors for postoperative recurrence in patients with SPN were conducted by searching in China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Web of Science and Embase database from inception of these databases to November 2022. Two investigators screened the collected literatures independently according to the inclusion and exclusion criteria, extracted the data and evaluated the methodological quality, and then used Review Manager 5.4 for statistical analysis, odds ratio ( OR) was calculated with 95% confidence interval ( CI). Results:A total of 14 articles were included, including 1 409 patients with 67 cases in recurrence group and 1 342 cases in non-recurrence group. Twelve risk factors with predictive value for postoperative recurrence of SPN were extracted from the literatures. The analysis showed that the pooled OR and 95% CI of each risk factor were gender ( OR=0.75, 95% CI 0.35-1.59, P=0.450), age( OR=-2.08, 95% CI -5.24-1.08, P=0.200), tumor diameter( OR=5.29, 95% CI 4.71-5.87, P<0.001), tumor location( OR=0.56, 95% CI 0.28-1.13, P=0.100), synchronous metastasis( OR=86.84, 95% CI 22.64-333.05, P<0.001), lymph node metastasis ( OR=7.55, 95% CI 2.58-22.06, P<0.001), perineural invasion ( OR=2.10, 95% CI 0.98-4.48, P=0.060), positive margin( OR=7.00, 95% CI 2.56-19.15, P<0.001), calcification( OR=0.49, 95% CI 0.11-2.23, P=0.360), lymphovascular invasion( OR=11.22, 95% CI 4.81-26.18, P<0.001), peripancreatic soft tissue invasion( OR=1.38, 95% CI 0.48-4.00, P=0.550), capsular invasion( OR=1.72, 95% CI 0.53-5.65, P=0.370). Conclusion:Large tumor diameter, synchronous metastasis, lymph node metastasis, positive margin, lymphovascular invasion increase the risk of recurrence of pancreatic SPN after resection, and patients with these characteristics should receive long-term follow-up.