Outcomes of surgical resection for pulmonary metastasis from pancreatic cancer

Surg Today. 2023 Nov;53(11):1236-1246. doi: 10.1007/s00595-023-02701-0. Epub 2023 Jun 14.

Abstract

Purpose: As the number of long-term survivors of pancreatic cancer is expected to increase thanks to recent advances in multidisciplinary treatment and earlier diagnoses of pancreatic cancer, we are likely to encounter more cases of postoperative pulmonary nodules. We analyzed the clinical course and prognosis of resection of pulmonary metastases from pancreatic cancer to clarify the prognostic implication of pulmonary metastasectomy for pancreatic cancer.

Method: We retrospectively analyzed 35 patients who underwent resection of lung metastases after pancreatic cancer surgery. Short- and long-term outcomes and factors associated with the prognosis were analyzed.

Results: The observation period was 20 (range, 1-101) months, with 3- and 5-year survival rates of 88.3% and 64.5% from pancreatectomy and 44.1% and 28.3% from lung resection, respectively. A univariate analysis revealed that a period from pancreatic cancer resection to pulmonary nodule shadow detection of < 15 months was associated with a significantly lower overall survival from pancreatic resection than a longer period. Conversely, histological type, stage, size of lung metastases, and resection technique were not associated with the overall survival.

Conclusion: A long-term prognosis may be expected in some cases with a disease-free interval of ≥ 15 months. Our findings suggest that the disease-free interval may influence the prognosis.

Keywords: Pancreatic cancer; Pulmonary metastasectomy; Pulmonary metastasis.

MeSH terms

  • Cancer Survivors*
  • Humans
  • Lung Neoplasms*
  • Pancreatic Neoplasms* / pathology
  • Pneumonectomy
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome