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Initial pulmonary metastasis after pancreatectomy for pancreatic ductal adenocarcinoma

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Abstract

Patients who undergo pancreatectomy for pancreatic ductal adenocarcinoma (PDA) develop relatively early recurrence, but pulmonary metastasis from PDA is rare. Between January 2008 and December 2016, a total of 120 consecutive patients underwent pancreatectomy for primary PDA at Osaka Medical College Hospital. Among these, 13 patients developed pulmonary metastasis and 6 patients underwent pulmonary metastasectomy. Among these patients, the median disease-free survival following initial pancreatic surgery was 26.1 months, and the median overall survival (OS) interval was 39 months. On the other hand, seven patients did not undergo pulmonary resection. The median OS interval of these patients was 33 months. The 1-, 3-, and 5-year OS rates were 100%, 80%, and 60%, respectively, for patients who underwent pulmonary metastasectomy and 100.0%, 42.8%, and 0%, respectively, for those who did not undergo the procedure. Our experience has shown that surgical resection may lengthen the survival time of patients who tolerate surgery.

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Fig. 1

Abbreviations

BSC:

Best supportive care

CA:

Carbohydrate antigen

CEA:

Carcinoembryonic antigen

CT:

Computed tomography

DFS:

Disease-free survival

DP:

Distal pancreatectomy

DUPAN-2:

Pancreatic cancer-associated antigen-2

FDG-PET:

Fluorodeoxyglucose-positron emission tomography

GEM:

Gemcitabine

OS:

Overall survival

PD:

Pancreaticoduodenectomy

PDA:

Pancreatic ductal adenocarcinoma

S-1:

Tegafur/gimeracil/oteracil

SPan-1:

s-Pancreas-1 antigen

TP:

Total pancreatectomies

UICC:

Unio Internationalis Contra Cancrum

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Acknowledgements

We thank all staff of Osaka Medical College for the management of patients. We would also like to thank Editage (www.editage.com) for editing the English language of this manuscript.

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None.

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Author notes

  1. Tetsunosuke Shimizu and Kohei Taniguchi equally contributed to this work.

Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Tetsunosuke Shimizu, Kohei Taniguchi, Mitsuhiro Asakuma, Koji Komeda, Yoshihiro Inoue, Sang-Woong Lee, Fumitoshi Hirokawa & Kazuhisa Uchiyama

  2. Translational Research Program, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Kohei Taniguchi

Authors
  1. Tetsunosuke Shimizu
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  2. Kohei Taniguchi
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  3. Mitsuhiro Asakuma
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  4. Koji Komeda
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  5. Yoshihiro Inoue
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  7. Fumitoshi Hirokawa
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  8. Kazuhisa Uchiyama
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Contributions

Conception and design of the study: TS and KT. Acquisition of data: TS, FH, and MA. Analysis and interpretation of the data: TS, KK, YI, SWL, and KT. Writing, review, and/or revision of the manuscript: TS, KT, and KU. Study supervision: KU. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Tetsunosuke Shimizu.

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The authors declare no conflicts of interest in association with the present study.

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Shimizu, T., Taniguchi, K., Asakuma, M. et al. Initial pulmonary metastasis after pancreatectomy for pancreatic ductal adenocarcinoma. Surg Today 50, 413–418 (2020). https://doi.org/10.1007/s00595-019-01902-w

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