Skip to main content
SpringerLink
Log in

A Retrospective Analysis of Preoperative Evaluation and Surgical Resection for Metastatic Tumors of the Pancreas

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Pancreatectomy might confer a survival benefit in patients with metastatic tumors of the pancreas (MTPs); however, the optimal treatment for MTP has not been established. We reviewed six patients with MTP undergoing pancreatectomy and discussed the clinical features, surgical treatment, and survival. The sites of primary cancer included renal cell carcinoma (RCC) (n = 5; 83.3%) and rectal cancer (n = 1; 16.7%). The median interval between the resection of the primary site and the development of MTP was 157 months (range, 16–180 months). Three (60.0%) of the five cases of MTP-originating RCC and a MTP-originating rectal cancer, biopsy was performed under endoscopic ultrasonography guidance and MTP was pathologically diagnosed. All patients with MTP originating from RCC have remained alive for 3, 13, 18, 18, and 113 months without recurrence after pancreatectomy. In contrast, the patient with MTP originating from rectal cancer developed multiple liver metastases at 7 months after pancreatectomy, and then underwent chemotherapy. A preoperative pathological diagnosis using biopsy under endoscopic ultrasonography guidance was indispensable for the treatment of MTP. Pancreatectomy for MTP conferred a survival benefit in patients with metastatic RCC, whereas a combination of pancreatectomy and chemotherapy might be necessary to improve the prognosis of patients with metastatic colorectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Adsay NV, Andea A, Basturk O, Kilinc N, Nassar H, Cheng JD (2004) Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature. Virchows Arch 444:527–535. https://doi.org/10.1007/s00428-004-0987-3

    Article  PubMed  Google Scholar 

  2. Sohn TA, Yeo CJ, Cameron JL, Nakeeb A, Lillemoe KD (2001) Renal cell carcinoma metastatic to the pancreas: results of surgical management. J Gastrointest Surg 5:346–351

    Article  CAS  PubMed  Google Scholar 

  3. Wente MN, Bergmann F, Fröhlich BE, Schirmacher P, Büchler MW, Friess H (2004) Pancreatic metastasis from gastric carcinoma: a case report. World J Surg Oncol 2:43. https://doi.org/10.1186/1477-7819-2-43

    Article  PubMed  PubMed Central  Google Scholar 

  4. Adler H, Redmond CE, Heneghan HM, Swan N, Maguire D, Traynor O, Hoti E, Geoghegan JG, Conlon KC (2014) Pancreatectomy for metastatic disease: a systematic review. Eur J Surg Oncol 40:379–386. https://doi.org/10.1016/j.ejso.2013.12.022

    Article  CAS  PubMed  Google Scholar 

  5. Hung JH, Wang SE, Shyr YM, Su CH, Chen TH, Wu CW (2012) Resection for secondary malignancy of the pancreas. Pancreas 41:121–129. https://doi.org/10.1097/MPA.0b013e31821fc8f2

    Article  PubMed  Google Scholar 

  6. Sweeney AD, Wu MF, Hilsenbeck SG, Brunicardi FC, Fisher WE (2009) Value of pancreatic resection for cancer metastatic to the pancreas. J Surg Res 156:189–198. https://doi.org/10.1016/j.jss.2009.01.017

    Article  PubMed  Google Scholar 

  7. Reddy S, Edil BH, Cameron JL, Pawlik TM, Herman JM, Gilson MM, Campbell KA, Schulick RD, Ahuja N, Wolfgang CL (2008) Pancreatic resection of isolated metastases from nonpancreatic primary cancers. Ann Surg Oncol 15:3199–3206. https://doi.org/10.1245/s10434-008-0140-7

    Article  PubMed  Google Scholar 

  8. Strobel O, Hackert T, Hartwig W, Bergmann F, Hinz U, Wente MN, Fritz S, Schneider L, Büchler MW, Werner J (2009) Survival data justifies resection for pancreatic metastases. Ann Surg Oncol 16:3340–3349. https://doi.org/10.1245/s10434-009-0682-3

    Article  PubMed  Google Scholar 

  9. Brierley JD, Gospodarowicz MK, Wittekind C (2017) TNM classification of malignant tumours, eighth edn. Wiley, Chichester

    Google Scholar 

  10. Le Borgne J, Partensky C, Glemain P, Dupas B, de Kerviller B (2000) Pancreaticoduodenectomy for metastatic ampullary and pancreatic tumors. Hepatogastroenterology 47:540–544

    PubMed  Google Scholar 

  11. Hiotis SP, Klimstra DS, Conlon KC, Brennan MF (2002) Results after pancreatic resection for metastatic lesions. Ann Surg Oncol 9:675–679

    Article  PubMed  Google Scholar 

  12. Søreide JA, Sandvik OM, Søreide K (2016) Improving pancreas surgery over time: performance factors related to transition of care and patient volume. Int J Surg 32:116–122. https://doi.org/10.1016/j.ijsu.2016.06.046

    Article  PubMed  Google Scholar 

  13. Madkhali AA, Shin SH, Song KB, Lee JH, Hwang DW, Park KM, Lee YJ, Kim SC (2018) Pancreatectomy for a secondary metastasis to the pancreas: a single institution experience. Medicine (Baltimore) 97:e 12653. https://doi.org/10.1097/MD.0000000000012653

    Article  Google Scholar 

  14. Fikatas P, Klein F, Andreou A, Schmuck RB, Pratschke J, Bahra M (2016) Long term survival after surgical treatment of renal cell carcinoma metastasis within the pancreas. Anticancer Res 36:4273–4278

    CAS  PubMed  Google Scholar 

  15. Cheng SK, Chuah KL (2016) Metastatic renal cell carcinoma to the pancreas : a review. Arch Pathol Lab Med 140:598–602. https://doi.org/10.5858/arpa.2015-0135-RS

    Article  CAS  PubMed  Google Scholar 

  16. Sun PJ, Yu YH, Cui XJ (2018) Primary clear cell adenocarcinoma of the pancreas: a case report and literature update. Onco Targets Ther 16(11):8197–8200. https://doi.org/10.2147/OTT.S183054

    Article  Google Scholar 

  17. Falconi M, Eriksson B, Kaltsas G, Bartsch DK, Capdevila J, Caplin M, Kos-Kudla B, Kwekkeboom D, Rindi G, Klöppel G, Reed N, Kianmanesh R, Jensen RT, Vienna Consensus Conference participants (2016) ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology 103:153–171. https://doi.org/10.1159/000443171

    Article  CAS  PubMed  Google Scholar 

  18. Tsutsumi K, Ohtsuka T, Mori Y, Fujino M, Yasui T, Aishima S, Takahata S, Nakamura M, Ito T, Tanaka M (2012) Analysis of lymph node metastasis in pancreatic neuroendocrine tumors (PNETs) based on the tumor size and hormonal production. J Gastroenterol 47:678–685. https://doi.org/10.1007/s00535-012-0540-0

    Article  CAS  PubMed  Google Scholar 

  19. Z'graggen K, Fernández-del Castillo C, Rattner DW, Sigala H, Warshaw AL (1998) Metastases to the pancreas and their surgical extirpation. Arch Surg 133:413–419

    Article  CAS  PubMed  Google Scholar 

  20. Nakeeb A, Lillemoe KD, Cameron JL (1995) The role of pancreaticoduodenectomy for locally recurrent or metastatic carcinoma to the periampullary region. J Am Coll Surg 180:188–192

    CAS  PubMed  Google Scholar 

  21. Grassi P, Verzoni E, Mariani L, De Braud F, Coppa J, Mazzaferro V, Procopio G (2013) Prognostic role of pancreatic metastases from renal cell carcinoma: results from an Italian center. Clin Genitourin Cancer 11:484–488. https://doi.org/10.1016/j.clgc.2013.04.022

    Article  PubMed  Google Scholar 

  22. Santoni M, Conti A, Partelli S, Porta C, Sternberg CN, Procopio G, Bracarda S, Basso U, De Giorgi U, Derosa L, Rizzo M, Ortega C, Massari F, Iacovelli R, Milella M, Di Lorenzo G, Buti S, Cerbone L, Burattini L, Montironi R, Santini D, Falconi M, Cascinu S (2015) Surgical resection does not improve survival in patients with renal metastases to the pancreas in the era of tyrosine kinase inhibitors. Ann Surg Oncol 22:2094–2100. https://doi.org/10.1245/s10434-014-4256-7

    Article  PubMed  Google Scholar 

  23. Stoltz A, Barnoud R, Plok V, Ducerf C, Baulieux J, Mabrut JY (2011) A pancreatic metastasis from a colon cancer. Clin Res Hepatol Gastroenterol 35:586–589. https://doi.org/10.1016/j.clinre.2010.12.004

    Article  CAS  PubMed  Google Scholar 

  24. Matsubara N, Baba H, Okamoto A, Kurata M, Tsuruta K, Funata N, Ashizawa K (2007) Rectal cancer metastasis to the head of the pancreas treated with pancreaticoduodenectomy. J Hepato-Biliary-Pancreat Surg 14:590–594. https://doi.org/10.1007/s00534-007-1219-4

    Article  Google Scholar 

  25. Palmowski M, Hacke N, Satzl S, Klauss M, Wente MN, Neukamm M, Kleeff J, Hallscheidt P (2008) Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology 8:199–203. https://doi.org/10.1159/000128556

    Article  PubMed  Google Scholar 

  26. Al Bandar MH, Kim NK (2017) Current status and future perspectives on treatment of liver metastasis in colorectal cancer (review). Oncol Rep 37:2553–2564. https://doi.org/10.3892/or.2017.5531

    Article  CAS  PubMed  Google Scholar 

  27. Kato T, Yasui K, Hirai T, Kanemitsu Y, Mori T, Sugihara K, Mochizuki H, Yamamoto J (2003) Therapeutic results for hepatic metastasis of colorectal cancer with special reference to effectiveness of hepatectomy: analysis of prognostic factors for 763 cases recorded at 18 institutions. Dis Colon Rectum 46:S22–S31. https://doi.org/10.1097/01.DCR.0000089106.71914.00

    Article  PubMed  Google Scholar 

  28. Crippa S, Angelini C, Mussi C, Bonardi C, Romano F, Sartori P, Uggeri F, Bovo G (2016) Surgical treatment of metastatic tumors to the pancreas: a single center experience and review of the literature. World J Surg 30:1536–1542. https://doi.org/10.1007/s00268-005-0464-4

    Article  Google Scholar 

  29. Jarufe N, McMaster P, Mayer AD, Mirza DF, Buckels JA, Orug T, Tekin K, Bramhall SR (2005) Surgical treatment of metastases to the pancreas. Surgeon 3:79–83

    Article  CAS  PubMed  Google Scholar 

  30. Watanabe T, Muro K, Ajioka Y, Hashiguchi Y, Ito Y, Saito Y, Hamaguchi T, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kawano H, Kinugasa Y, Kokudo N, Murofushi K, Nakajima T, Oka S, Sakai Y, Tsuji A, Uehara K, Ueno H, Yamazaki K, Yoshida M, Yoshino T, Boku N, Fujimori T, Itabashi M, Koinuma N, Morita T, Nishimura G, Sakata Y, Shimada Y, Takahashi K, Tanaka S, Tsuruta O, Yamaguchi T, Yamaguchi N, Tanaka T, Kotake K, Sugihara K, Japanese Society for Cancer of the Colon and Rectum (2018) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol 23:1–34. https://doi.org/10.1007/s10147-017-1101-6

    Article  PubMed  Google Scholar 

  31. Araujo RL, Gönen M, Herman P (2015) Chemotherapy for patients with colorectal liver metastases who underwent curative resection improves long-term outcomes: systematic review and meta-analysis. Ann Surg Oncol 22:3070–3078. https://doi.org/10.1245/s10434-014-4354-6

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan

    Yuhei Endo, Hiroshi Noda, Fumiaki Watanabe, Takaharu Kato, Nao Kakizawa, Kosuke Ichida, Naoya Kasahara & Toshiki Rikiyama

Authors
  1. Yuhei Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroshi Noda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fumiaki Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takaharu Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nao Kakizawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kosuke Ichida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Naoya Kasahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshiki Rikiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroshi Noda.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Institutional Review Board Statement

This study was reviewed and approved by the Ethics Committee of Saitama Medical Center, Jichi Medical University.

Informed Consent Statement

Patients were not required to give their informed consent for inclusion in this retrospective study because we used anonymous clinical data and no individuals could be identified from the data. We announced this study on our institution’s website with an explanation about the patients’ right to refuse inclusion in the present study and about the study’s publication.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Endo, Y., Noda, H., Watanabe, F. et al. A Retrospective Analysis of Preoperative Evaluation and Surgical Resection for Metastatic Tumors of the Pancreas. Indian J Surg Oncol 10, 251–257 (2019). https://doi.org/10.1007/s13193-019-00905-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-019-00905-w

Keywords

Search

Navigation