Surgery for metastasis to the pancreas: is it safe and effective?

J Surg Oncol. 2013 Jun;107(8):859-64. doi: 10.1002/jso.23333. Epub 2013 May 1.

Abstract

Background: Pancreatic metastases are rare and only sparse data exists on treatment options. After recent advances in pancreatic surgery, metastasectomies have become promising treatment alternatives.

Methods: Twenty-six patients underwent pancreatic metastasectomy between 1991 and 2010 at our institution. Data was evaluated retrospectively.

Results: Renal cell carcinoma was the most common origin of pancreatic metastases (n = 16; 62%). Other primaries include gall bladder carcinoma, leiomyosarcoma, colon cancer (all n = 2), and others. The median time interval between primary tumor and pancreatic resection was 5.3 years [0-24]. Eleven pancreatic head resections (42%), fourteen distal pancreatectomies (54%), and one total pancreatectomy were performed (4%). The estimated 3- and 5-year survival rates were 73.2% and 52.3%, respectively. The estimated median overall survival was 63 months (CI: 37.8-88.1 months). There' was no perioperative death. The complication rate and relaparotomy rate was 31% and 19%, respectively. Patients suffering from synchronous metastases at the time of pancreatic surgery had a statistically significant shorter median overall survival time (11 months vs. 64 months).

Conclusions: Despite the operative risk involved, we believe that pancreatic resection should be considered in selected patients with good performance status, stable disease and isolated pancreatic metastases.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Neoplasms / pathology*
  • Length of Stay
  • Male
  • Middle Aged
  • Morbidity
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm, Residual / diagnosis
  • Pancreatectomy* / adverse effects
  • Pancreatectomy* / methods
  • Pancreatic Neoplasms / secondary*
  • Pancreatic Neoplasms / surgery*
  • Retrospective Studies
  • Treatment Outcome