Annals of Surgical Oncology

, Volume 9, Issue 7, pp 675–679 | Cite as

Results after pancreatic resection for metastatic lesions

  • Spiros P. Hiotis
  • David S. Klimstra
  • Kevin C. Conlon
  • Murray F. Brennan
Original Articles



Unlike primary pancreatic carcinoma, isolated metastatic lesions to the pancreas are uncommon. Although the value of surgical resection is poorly documented, resection may be deemed appropriate in selected cases. The aim of this study was to review our experience with the operative management of pancreatic metastases


Sixteen patients who underwent pancreatic resection for the treatment of metastatic disease were identified from a prospective pancreatic database. The clinical features of and results after resection were examined.


Renal cell carcinoma was the most frequent primary histopathology (10 of 16; 62%). In the remaining patients, the primary histopathology was non-small-cell lung cancer (n=3), sarcoma (n=1), melanoma (n=1), or transitional cell carcinoma of the bladder (n=1). A prolonged disease-free interval (median, 7.5 years) was characteristic of most patients. Operative procedures performed included eight pancreaticoduodenectomies, seven distal pancreatectomies, and one total pancreatectomy. The operative mortality was 6%, and the morbidity was 25%. The overall 2- and 5-year actuarial survival rates were 62% and 25%, respectively. A trend toward improved survival was observed in the renal cell carcinoma patients, but this finding was not statistically significant.


Long-term survival after pancreatic resection for metastatic disease is achievable, and patients with primary renal cell carcinoma seem to have a more favorable prognosis. Surgical resection should thus be offered to selected patients with isolated metastatic disease to the pancreas.

Key Words

Pancreas neoplasm Metastasis Renal cell carcinoma Pancreatectomy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Weber SM, Jarnagin WR, DeMatteo RP, Blumgart LH, Fong Y. Survival after resection of multiple hepatic colorectal metastases.Ann Surg Oncol 2000;7:643–50.PubMedCrossRefGoogle Scholar
  2. 2.
    Billingsley KG, Lewis JJ, Leung DH, Casper ES, Woodruff JM, Brennan MF. Multifactorial analysis of the survival of patients with distant metastasis arising from primary extremity sarcoma.Cancer 1999;85:389–95.PubMedCrossRefGoogle Scholar
  3. 3.
    Bindal RK, Sawaya R, Leavens ME, Lee JJ. Surgical treatment of multiple brain metastases.J Neurosurg 1993;79:210–6.PubMedGoogle Scholar
  4. 4.
    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.PubMedGoogle Scholar
  5. 5.
    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.PubMedCrossRefGoogle Scholar
  6. 6.
    Ghavamian R, Klein KA, Stephens DH, et al. Renal cell carcinoma metastatic to the pancreas: clinical and radiological features.Mayo Clin Proc 2000;75:581–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Faure JP, Tuech JJ, Richer JP, Pessaux P, Arnaud JP, Carretier M. Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival.J Urol 2001;165:20–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Roland CF, van Heerden JA. Nonpancreatic primary tumors with metastasis to the pancreas.Surg Gynecol Obstet 1989;168:345–7.PubMedGoogle Scholar
  9. 9.
    Kassabian A, Stein J, Jabbour N, et al. Renal cell carcinoma metastatic to the pancreas: a single-institution series and review of the literature.Urology 2000;56:211–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Barras JP, Baer H, Stenzl A, Czerniak A. Isolated late metastasis of a renal cell cancer treated by radical distal pancreatectomy.HPB Surg 1996;10:51–3.PubMedGoogle Scholar
  11. 11.
    Hirota T, Tomida T, Iwasa M, Takahashi K, Kaneda M, Tamaki H. Solitary pancreatic metastasis occurring eight years after nephrectomy for renal cell carcinoma. A case report and surgical review.Int J Pancreatol 1996;19:145–53.PubMedGoogle Scholar
  12. 12.
    Paz A, Koren R, Gal R, Wolloch Y. Late solitary pancreatic metastasis from renal cell carcinoma.Isr J Med Sci 1996;32:1319–21.PubMedGoogle Scholar
  13. 13.
    Stankard CE, Karl RC. The treatment of isolated pancreatic metastases from renal cell carcinoma: a surgical review.Am J Gastroenterol 1992;87:1658–60.PubMedGoogle Scholar
  14. 14.
    Hashimoto M, Watanabe G, Matsuda M, Dohi T, Tsurumaru M. Management of the pancreatic metastases from renal cell carcinoma: report of four resected cases.Hepatogastroenterology 1998; 45:1150–4.PubMedGoogle Scholar
  15. 15.
    Balcom JH IV, Rattner DW, Warshaw AL, Chang Y, Fernandezdel Castillo C. Ten-year experience with 733 pancreatic resections: changing indications, older patients, and decreasing length of hospitalization.Arch Surg 2001;136:391–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarcinoma of the pancreas—616 patients: results, outcomes, and prognostic indicators.J Gastrointest Surg 2000;4:567–79.PubMedCrossRefGoogle Scholar
  17. 17.
    Porter GA, Pisters PW, Mansyur C, et al. Cost and utilization impact of a clinical pathway for patients undergoing pancreaticoduodenectomy.Ann Surg Oncol 2000;7:484–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Tsiotos GG, Farnell MB, Sarr MG. Are the results of pancreatectomy for pancreatic cancer improving?World J Surg 1999;23: 913–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Conlon KC, Klimstra DS, Brennan MF. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinico-pathologic analysis of 5-year survivors.Ann Surg 1996;223:273–9.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Surgical Oncology, Inc 2002

Authors and Affiliations

  • Spiros P. Hiotis
    • 1
  • David S. Klimstra
    • 2
  • Kevin C. Conlon
    • 1
  • Murray F. Brennan
    • 1
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York
  2. 2.Department of PathologyMemorial Sloan-Kettering Cancer CenterNew York

Personalised recommendations