Skip to main content

Advertisement

Log in

Survival Data Justifies Resection for Pancreatic Metastases

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Pancreatic metastases are uncommon and little is known about the oncologic outcome after resection or prognostic parameters. This study was designed to evaluate perioperative and follow-up results after resection for pancreatic metastases and to define prognostic factors.

Methods

From a prospective database, all consecutive resections performed at our institution for pancreatic metastases between October 2001 and July 2008 were identified. Clinicopathological details, perioperative, and follow-up results were analyzed. Uni- and multivariate analysis were performed to identify parameters associated with overall and disease-free survival.

Results

Forty-four resections were performed for pancreatic metastases. Primary tumors included 31 (70%) renal cell carcinomas (RCC) and 13 other primary tumors. Morbidity was 33% and mortality 4.4%. Pancreatic metastases occurred after a median interval of 6.9 years after resection of the primary tumor. Twenty-five patients (57%) had additional extrapancreatic disease. With a median follow-up of 32.1 months, overall 3- and 5-year survivals were 70.2% and 56.8%, disease-free 3- and 5-year survivals were 37.2% and 33%, respectively. Patients with isolated pancreatic metastases had an overall 3- and 5-year survival of 85.6% and 74.9%. Additional extrapancreatic disease, a disease-free interval of less than 36 months, and non-RCC entity were associated with shorter overall survival. Previous recurrence, non-RCC primary tumors, and a disease-free interval of less than 36 months were associated with shorter disease-free survival.

Conclusions

Resection for pancreatic metastases can be performed safely and with good follow-up results and can be recommended as part of an interdisciplinary treatment. Especially in patients with isolated pancreatic metastases, long-term survival can be expected.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Showalter SL, Hager E, Yeo CJ. Metastatic disease to the pancreas and spleen. Semin Oncol. 2008;3(5):160–71.

    Article  Google Scholar 

  2. Roland CF, van Heerden JA. Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet. 1989;168:345–7.

    CAS  PubMed  Google Scholar 

  3. Z’graggen K, Fernandez-del Castillo C, Rattner DW, Sigala H, Warshaw AL. Metastases to the pancreas and their surgical extirpation. Arch Surg. 1998;133:413–7.

    Article  PubMed  Google Scholar 

  4. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230:309–18.

    Article  CAS  PubMed  Google Scholar 

  5. Quiros RM, Scott WJ. Surgical treatment of metastatic disease to the lung. Semin Oncol. 2008;35:134–46.

    Article  PubMed  Google Scholar 

  6. Wente MN, Kleeff J, Esposito I, et al. Renal cancer cell metastasis into the pancreas: a single-center experience and overview of the literature. Pancreas. 2005;30:218–22.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  8. Sperti C, Pasquali C, Liessi G, Pinciroli L, Decet G, Pedrazzoli S. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol. 2003;83:161–6.

    Article  PubMed  Google Scholar 

  9. Crippa S, Angelini C, Mussi C, et al. Surgical treatment of metastatic tumors to the pancreas: a single center experience and review of the literature. World J Surg. 2006;30:1536–42.

    Article  PubMed  Google Scholar 

  10. Eidt S, Jergas M, Schmidt R, Siedek M. Metastasis to the pancreas-an indication for pancreatic resection? Langenbecks Arch Surg. 2007;392:539–42.

    Article  CAS  PubMed  Google Scholar 

  11. Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear cell renal carcinoma to the pancreas: an indication for pancreatic surgery. Ann Surg Oncol. 2006;13:75–85.

    Article  PubMed  Google Scholar 

  12. Tanis PJ, van der Gaag NA, Busch OR, van Gulik TM, Gouma DJ. Systematic review of pancreatic surgery for metastatic renal cell carcinoma. Br J Surg. 2009;96:579–92.

    Article  CAS  PubMed  Google Scholar 

  13. Reddy S, Edil BH, Cameron JL et al. Pancreatic resection of isolated metastases from nonpancreatic primary cancers. Ann Surg Oncol. 2008;15:3199–206.

    Article  PubMed  Google Scholar 

  14. Palmowski M, Hacke N, Satzl S, et al. Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology. 2008;8:199–203.

    Article  PubMed  Google Scholar 

  15. Hartwig W, Hackert T, Hinz U, et al. Multivisceral resection of pancreatic malignancies: risk-analysis and long-term outcome. Ann Surg. 2009;250:81–7.

    Article  PubMed  Google Scholar 

  16. Kaido T. Verification of evidence in surgical treatment for colorectal liver metastasis. Hepatogastroenterology. 2008;55:378–80.

    PubMed  Google Scholar 

  17. Internullo E, Cassivi SD, Van Raemdonck D, Friedel G, Treasure T. Pulmonary metastasectomy: a survey of current practice amongst members of the European Society of Thoracic Surgeons. J Thorac Oncol. 2008;3:1257–66.

    Article  PubMed  Google Scholar 

  18. Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350:1200–10.

    Article  CAS  PubMed  Google Scholar 

  19. Winter JM, Cameron JL, Campbell KA, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience. J Gastrointest Surg. 2006;10:1199–210.

    Article  PubMed  Google Scholar 

  20. Girard P, Ducreux M, Baldeyrou P, et al. Surgery for lung metastases from colorectal cancer: analysis of prognostic factors. J Clin Oncol. 1996;14:2047–53.

    CAS  PubMed  Google Scholar 

  21. Adam R, de Haas RJ, Wicherts DA, et al. Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement? J Clin Oncol. 2008;26:3672–80.

    Article  PubMed  Google Scholar 

  22. Tomlinson JS, Jarnagin WR, DeMatteo RP, et al. Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol. 2007;25:4575–80.

    Article  PubMed  Google Scholar 

  23. Zerbi A, Ortolano E, Balzano G, Borri A, Beneduce AA, Di CV. Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection? Ann Surg Oncol. 2008;15:1161–8.

    Article  PubMed  Google Scholar 

  24. Kavolius JP, Mastorakos DP, Pavlovich C, Russo P, Burt ME, Brady MS. Resection of metastatic renal cell carcinoma. J Clin Oncol. 1998;16:2261–6.

    CAS  PubMed  Google Scholar 

  25. Wente MN, Bergmann F, Frohlich BE, Schirmacher P, Buchler MW, Friess H. Pancreatic metastasis from gastric carcinoma: a case report. World J Surg Oncol. 2004;2:43.

    Article  PubMed  Google Scholar 

  26. Bassi C, Butturini G, Falconi M, Sargenti M, Mantovani W, Pederzoli P. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma. Br J Surg. 2003;90:555–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jens Werner MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Strobel, O., Hackert, T., Hartwig, W. et al. Survival Data Justifies Resection for Pancreatic Metastases. Ann Surg Oncol 16, 3340–3349 (2009). https://doi.org/10.1245/s10434-009-0682-3

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-009-0682-3

Keywords

Navigation