Journal of Gastrointestinal Surgery

, Volume 15, Issue 9, pp 1611–1617

Pulmonary Resection for Isolated Pancreatic Adenocarcinoma Metastasis: an Analysis of Outcomes and Survival

  • George J. Arnaoutakis
  • Deepa Rangachari
  • Daniel A. Laheru
  • Chris A. Iacobuzio-Donahue
  • Ralph H. Hruban
  • Joseph M. Herman
  • Barish H. Edil
  • Timothy M. Pawlik
  • Richard D. Schulick
  • John L. Cameron
  • Avedis Meneshian
  • Stephen C. Yang
  • Christopher L. Wolfgang
Original Article

DOI: 10.1007/s11605-011-1605-8

Cite this article as:
Arnaoutakis, G.J., Rangachari, D., Laheru, D.A. et al. J Gastrointest Surg (2011) 15: 1611. doi:10.1007/s11605-011-1605-8

Abstract

Objectives

This study was conducted to determine if pulmonary metastasectomy (PM) for isolated pancreatic cancer metastases is safe and effective.

Methods

This was a retrospective case–control study of patients undergoing PM at our institution from 2000 to 2009 for isolated lung metastasis after resection for pancreatic cancer. Clinical and pathologic data were compared with a matched reference group. Resected neoplasms were immunolabeled for the Dpc4 protein. Kaplan–Meier analysis compared overall survival and survival after relapse.

Results

Of 31 patients with isolated lung metastasis, 9 underwent 10 pulmonary resections. At initial pancreas resection, all patients were stage I or II. Other baseline characteristics were similar between the two groups. Median time from pancreatectomy to PM was 34 months (interquartile range 21–49). During the study, 29/31(90.6%) patients died. There were no in-hospital mortalities or complications after PM. Median cumulative survival was significantly improved in the PM group (51 vs. 23 months, p = 0.04). There was a trend toward greater 2-year survival after relapse in the PM group (40% vs. 27%, p = 0.2).

Conclusions

In patients with isolated lung metastasis from pancreatic adenocarcinoma, this is the first study to show that pulmonary resection can be performed safely with low morbidity and mortality. The improved survival in the PM group may result in part from selection bias but may also represent a benefit of the procedure.

Keywords

Metastatic adenocarcinoma Pancreatic adenocarcinoma Metastasectomy 

Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • George J. Arnaoutakis
    • 1
    • 3
  • Deepa Rangachari
    • 2
  • Daniel A. Laheru
    • 2
  • Chris A. Iacobuzio-Donahue
    • 2
    • 3
    • 5
  • Ralph H. Hruban
    • 2
    • 5
  • Joseph M. Herman
    • 4
  • Barish H. Edil
    • 2
    • 3
  • Timothy M. Pawlik
    • 2
    • 3
  • Richard D. Schulick
    • 3
  • John L. Cameron
    • 3
  • Avedis Meneshian
    • 1
  • Stephen C. Yang
    • 1
  • Christopher L. Wolfgang
    • 2
    • 3
  1. 1.Division of Thoracic Surgery, The Sol Goldman Pancreatic Cancer Research CenterThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  2. 2.Division of Medical Oncology, The Sol Goldman Pancreatic Cancer Research CenterThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.Division of Surgical Oncology, The Sol Goldman Pancreatic Cancer Research CenterThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  4. 4.Division of Radiation Oncology, The Sol Goldman Pancreatic Cancer Research CenterThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  5. 5.Department of Pathology, The Sol Goldman Pancreatic Cancer Research CenterThe Johns Hopkins Medical InstitutionsBaltimoreUSA