Summary
By measuring the doubling time of liver metastasis, the authors investigated the possibility of occult liver metastasis at the time of pancreatectomy in patients with pancreatic carcinoma. We calculated tumor doubling times of liver metastases in six patients after pancreatectomy for periampullary carcinoma and compared with cell doubling times. We also calculated the diameters of the occult liver metastases at the time of pancreatectomy on the assumption that the growth rates of liver metastasis were constant. Tumor doubling times of liver metastases in six patients were 34, 32, 318, 108, 78, and 27 d, respectively. In two of these patients, tumor doubling times, compared with cell doubling times of 51 and 52 h for PK-36 and PK-59 established from the same patients with carcinoma of the pancreas, were about 15 times as long as those of cultured cell lines. The calculated sizes of the occult liver metastases at the time of pancreatectomy in these six patients were 2.4, 0.14, 19.0, 8.2, 3.5, and 4.2 mm. In five of these six patients, the calculated sizes were in the range between 10 μm and 1 cm. These results indicated occult liver metastases had already existed in patients with carcinoma of the pancreas at the time of pancreatectomy and were too small to be detected by imaging technique. We cannot improve survival rates in carcinoma of the pancreas by surgical management alone. For further improvement in survival rate of patients with carcinoma of the pancreas to occur, effective adjuvant therapies to prevent liver metastases must complement surgical management.
Similar content being viewed by others
References
Committee of Pancreatic Cancer Registry (Chairman: Saitoh Y).Report of Pancreatic Cancer Registry, 1981–1990. Japan Pancreas Society, Kobe, Japan, 1991 (in Japanese).
Cameron JL, Crist DW, Sitzmann JV, Hruban RH, Boitnott JK, Seidler AJ, Coleman J. Factors influencing survival after pancreaticoduodenectomy for pancreatic cancerAm J Surg 1991; 161: 120–125.
Tsuchiya R, Oribe T, Noda T. Size of the tumor and other factors influencing prognosis of carcinoma of the head of the pancreas.Am J Gastroenterol 1985; 80: 459–462.
Ozaki H. Improvement of pancreatic cancer treatment from the Japanese experience in the 1980s.Int J Pancreatol 1992; 12: 5–9.
Matsuno S, Kato S, Kobari M, Sato T. Clinicopathological study on hematogenous metastasis of pancreatic cancer.Jpn J Surg 1986; 16: 406–411.
Westerdahl J, Andrén-Sandberg A, Ihse I. Recurrence of exocrine pancreatic cancer-local or hepatic?Hepatogastroenterology 1993; 40: 384–387.
Kobari M, Hisano H, Matsuno S, Sato T, Kan M, Tachibana T. Establishment of six human pancreatic cancer cell lines and their sensitivities to anti-tumor drugs.Tohoku J Exp Med 1986; 150: 231–248.
Collins VP, Loeffler RK, Tivey H. Observations on growth rates of human tumors.Am J Roentgenol 1956; 76: 988–1000.
Gudjonsson B, Livstone EM, Spiro HM. Cancer of the pancreas: diagnosis accuracy and survival statistics.Cancer 1978; 42: 2494–2506.
Gudjonsson B. Cancer of the pancreas—50 years of surgery.Cancer 1987; 60: 2084–2303.
Crist DW, Cameron JL. The current status of the whipple operation for periampullary carcinoma.Adv Surg 1992; 25: 21–49.
Collins VP. Time of occurrence of pulmonary metastasis from carcinoma of colon and rectum.Cancer 1962; 15: 387–395.
Kusama S, Spratt JS Jr, Donegan WL, Donegan WL, Watson FR, Cunningham C. The gross rates of growth of human mammary carcinoma.Cancer 1972; 30: 594–599.
Kusama S, Takahashi Y. Study on chronology of the patients with recurrent cancer.Shokaki Geka (Gastroenterol Surg) 1985; 8: 1189–1194 (in Japanese).
Finlay IG, Meek D, Brunton F, McArdle CS. Growth rate of hepatic metastases in colorectal carcinoma.Br J Surg 1988; 75: 641–644.
Sellner F, Machacek E. The importance of tumor volume in the prognosis of radically treated periampullary carcinomas.Eur J Surg 1993; 159: 95–100.
Bakkevold KE, Kambested B. Long-term survival following radical and palliative treatment of patients with carcinoma of the pancreas and papilla of Vater.,Eur J Surg Oncol 1993; 19: 147–161.
Matory YL, Gaynor J, Brennan M. Carcinoma of the ampulla of Vater,Surg Gyn Obstet 1993; 177: 366–370.
Monson JRT, Donohue JH, McEntee GP, McIlrath DC, van Heerden JA, Shorter RG, Nagomey DM, Ilstrup DM. Radical resection for carcinoma of the ampulla of Vater.Arch Surg 1991; 126: 353–357.
Kobari M, Akaishi S, Amikura K, Asano H, Kimura Y, Kawaguchi S, Hurukawa T, Matsuno S. Cellular immunological changes in early postoperative period after pancreaticoduodenectomy.J Jpn Pancreas Soc 1989; 4: 372–380 (in Japanese with English summary).
Matsuno S, Hisano H, Kobari M, Akaishi S. Growth-inhibitory effects of combination chemotherapy for human pancreatic cancer cell lines.Cancer 1990; 66: 2369–2374.
Yokoyama I, Carr B, Saitsu H, Iwatsuki S, Starzl TE. Accelerated growth rates of recurrent hepatocellular carcinoma after liver transplantation.Cancer 1991; 68: 2095–2100.
Marincola FM, Da Pozzo LF, Drucker BJ, Hoder WD Jr. Adoptive immunotherapy of human pancreatic cancer with lymphokine activated killer cells and interleukin-2 in a nude mouse model.Surgery 1990; 108: 919–929.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Amikura, K., Kobari, M. & Matsuno, S. The time of occurrence of liver metastasis in carcinoma of the pancreas. Int J Pancreatol 17, 139–146 (1995). https://doi.org/10.1007/BF02788531
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02788531