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Journal of Gastrointestinal Surgery

, Volume 20, Issue 6, pp 1188–1193 | Cite as

Pancreatic Metastasectomy—an Analysis of Survival Outcomes and Prognostic Factors

  • Terence C. Chua
  • Wilson Petrushnko
  • Anubhav Mittal
  • Anthony J. Gill
  • Jaswinder S. Samra
Original Article

Abstract

Background

The pancreas and peripancreatic region may be a site of metastasis from distant sites. Recent data suggest that pancreatic metastasectomy may achieve long-term survival. We seek to examine our experience with this metastasectomy by reporting the perioperative and survival outcomes.

Methods

Patients undergoing resection of isolated pancreatic metastasis were identified from a prospective pancreatic surgical database at the Department of Gastrointestinal Surgery, North Shore campus of the University of Sydney between January 2004 and June 2015 and selected for retrospective review. Data on operative morbidity and mortality were reported. Survival analysis was performed using the Kaplan–Meier method.

Results

Fifteen patients underwent pancreatic metastasectomy after a median disease-free interval of 63 months (range 0 to 199). Pancreatoduodenectomy was performed in six patients (40 %), distal pancreatectomy with or without splenectomy in three patients (20 %), and pancreatectomy with other visceral organ resection in six patients (40 %). Major complications occurred in six patients (40 %) without mortality. The median survival was 40 months (95 % CI 24.3 to 53.7), and 1-, 3-, and 5-year survival were 76, 48, and 31 % respectively. Cox proportional hazard model identified margin negative resection (hazard ratio (HR) 10.5; P = 0.044) as a predictor of improved survival.

Conclusion

Long-term survival may be achieved in selected patients with pancreatic metastasis through pancreatic metastasectomy with acceptable morbidity. Selection of patients should be individualized and based on their primary disease origin, biological behavior of the tumor, resectability of the tumor, and the relative effectiveness of systemic or targeted therapies.

Keywords

Pancreatoduodenectomy Metastasis Chemotherapy Pancreas Metastasectomy 

Notes

Compliance with Ethical Standards

Competing Interests

The authors declare that they have no competing interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2016

Authors and Affiliations

  • Terence C. Chua
    • 1
    • 2
  • Wilson Petrushnko
    • 1
    • 2
  • Anubhav Mittal
    • 1
    • 2
  • Anthony J. Gill
    • 3
    • 4
    • 5
  • Jaswinder S. Samra
    • 1
    • 2
    • 6
  1. 1.Department of Gastrointestinal SurgeryRoyal North Shore HospitalSt LeonardsAustralia
  2. 2.Discipline of SurgeryUniversity of SydneySydneyAustralia
  3. 3.Cancer Diagnosis and Pathology GroupKolling Institute of Medical ResearchSt LeonardsAustralia
  4. 4.University of SydneySydneyAustralia
  5. 5.Department of Anatomical PathologyRoyal North Shore HospitalSt LeonardsAustralia
  6. 6.Macquarie University HospitalMacquarie UniversitySydneyAustralia

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