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Surgical Treatment of Metastatic Tumors to the Pancreas: A Single Center Experience and Review of the Literature

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Abstract

Background

Unlike primary pancreatic carcinoma, metastases to the pancreas are rare, and their resection may be performed as palliative treatment. The aim of this study was to review our experience with the operative management of pancreatic metastases.

Materials and Methods

Between January 1994 and December 2004 13 patients (nine women and four men; median age: 59 years; range: 36–79 years) were admitted to our institution with metastatic lesion to the pancreas. The clinical features of the treatment and results were examined.

Results

Primary tumors were renal cell carcinoma (n = 5), lobular carcinoma of the breast (n = 3), endometrioid carcinoma of the ovary (n = 1), colonic adenocarcinoma (n = 1), jejunal leiomyosarcoma (n = 1), melanoma (n = 1), and non-small-cell lung cancer (n = 1). The median interval between primary tumor and pancreatic metastases was 36 months (range: 5–192 months). Six patients (46%) were asymptomatic, while the other seven patients presented with jaundice, pain, and duodenal obstruction. Two patients with extrapancreatic disease underwent palliative surgery, and the remaining 11 patients underwent operative procedures that included seven pancreaticoduodenectomy and four distal pancreatectomies with splenectomy. Postoperative mortality was nil, and the morbidity rate was 30%. The two patients who underwent palliative surgery died after 7 and 9 months, respectively. The median survival of the resected patients was 26 months (range: 13–95 months). Five patients died of disease, eight are alive at the time of this report.

Conclusion

A trend towards improved survival, even if not statistically significant, was observed in the renal carcinoma patients reported here. Surgical resection can be performed safely in selected patients with isolated metastases to the pancreas, achieving long-term survival as well as good palliation.

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References

  1. Z’graggen K, Fernandez-del Castillo C, Rattner DW, et al. Metastases to the pancreas and their surgical extirpation. Arch Surg 1998;133:413–417

    Article  PubMed  CAS  Google Scholar 

  2. Adsay NV, Andea A, Basturk O, et al. Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature. Virchows Arch 2004;444:527–535

    Article  PubMed  Google Scholar 

  3. Washington K, McDonagh D. Secondary tumors of the gastrointestinal tract: surgical pathologic findings and comparison with autopsy survey. Mod Pathol 1995;8:427–433

    PubMed  CAS  Google Scholar 

  4. Roland CJ, van Heerden JA. Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet 1989;168:345–347

    PubMed  CAS  Google Scholar 

  5. Brady LW, O’Neill EA, Farber SH. Unusual sites of metastases. Semin Oncol 1977;4:59–64

    PubMed  CAS  Google Scholar 

  6. Sperti C, Pasquali C, Liessi G, et al. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol 2003;83:161–166

    Article  PubMed  Google Scholar 

  7. Poston GJ. Surgical strategies for colorectal liver metastases. Surg Oncol 2004;13:125–136

    Article  PubMed  Google Scholar 

  8. Weitz J, Blumgart LH, Fong Y, et al. Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann Surg 2005;241:269–276

    Article  PubMed  Google Scholar 

  9. Hart M, Grant R, Walker M, Dickinson H. Surgical resection and whole brain radiation therapy versus whole brain radiation therapy alone for single brain metastases. Cochrane Database Syst Rev 2005;1:CD003292

    PubMed  Google Scholar 

  10. Hiotis S, Klimstra DS, Conlon KC, et al. Results after pancreatic resection for metastatic lesions. Ann Surg Oncol 2002;9:675–679

    Article  PubMed  Google Scholar 

  11. Medina-Franco H, Halpern NB, Aldrete JS. Pancreaticoduodenectomy for metastatic tumors to the periampullary region. J Gastrointest Surg 1999;3:119–122

    Article  PubMed  CAS  Google Scholar 

  12. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s. Pathology, complications and outcome. Ann Surg 1997;226:248–260

    Article  PubMed  CAS  Google Scholar 

  13. Le Borgne J, Partensky C, Glemain P, et al. Pancreaticoduodenectomy for metastatic ampullary and pancreatic tumors. Hepatogastroenterology 2000;47:540–544

    PubMed  CAS  Google Scholar 

  14. Faure JP, Tuech JJ, Richer JP, et al. Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. J Urol 2001;165:20–22

    Article  PubMed  CAS  Google Scholar 

  15. Law CHL, Wei AC, Hanna SS, et al. Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment and outcome. Ann Surg Oncol 2003;10:922–926

    Article  PubMed  Google Scholar 

  16. 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;56:211–215

    Article  PubMed  CAS  Google Scholar 

  17. Minni F, Casadei R, Perenze B, et al. Pancreatic metastases: observations of three cases and review of the literature. Pancreatology 2004;4:509–520

    Article  PubMed  Google Scholar 

  18. Sohn TA, Yeo CY, Cameron JL, et al. Renal cell carcinoma metastatic to the pancreas: results of a surgical management. J Gastrointest Surg 2001;5:346–351

    Article  PubMed  CAS  Google Scholar 

  19. Crippa S, Bonardi C, Bovo G, et al. Pancreaticoduodenectomy for pancreatic metastases from breast carcinoma. J Pancreas 2004;5:5001–5007

    Google Scholar 

  20. Sobesky R, Duclos-Vallee JC, Prat F, et al. Acute pancreatitis revealing diffuse infiltration of the pancreas by melanoma. Pancreas 1997;15:213–215

    Article  PubMed  CAS  Google Scholar 

  21. Yamamoto H, Watanabe K, Nagata M, et al. Surgical treatment for pancreatic metastasis from soft-tissue sarcoma. Am J Clin Oncol 2001;24:198–200

    Article  PubMed  CAS  Google Scholar 

  22. Muranaka T, Teshima K, Honda H, et al. Computed tomography and histologic appearance of pancreatic metastases from distant sources. Acta Radiol 1989;30:615–619

    Article  PubMed  CAS  Google Scholar 

  23. Merkle EM, Boaz T, Kolokythas O, et al. Metastases to the pancreas. Br J Radiol 1998;71:1208–1214

    PubMed  CAS  Google Scholar 

  24. Klein KA, Stephens DH, Wech TJ. CT characteristics of metastatic disease of the pancreas. Radiographics 1998;18:369–378

    PubMed  CAS  Google Scholar 

  25. Ghavamian R, Klein KA, Stephens DH, et al. Renal cell carcinoma metastatic to the pancreas: clinical and radiological features. Mayo Clin Proc 2000;75:581–585

    Article  PubMed  CAS  Google Scholar 

  26. Hustinx R. PET imaging in assessing gastrointestinal tumors. Radiol Clin North Am 2004;42:1123–1139

    Article  PubMed  Google Scholar 

  27. Hughes JH, Jensen CS, Donnelly AD, et al. The role of fine-needle aspiration cytology in the evaluation of metastatic clear cell tumors. Cancer 1999;87:380–389

    Article  PubMed  CAS  Google Scholar 

  28. Thompson LDR, Heffess CS. Renal cell carcinoma to the pancreas in surgical pathology material. Cancer 2000;89:1076–1088

    Article  PubMed  CAS  Google Scholar 

  29. Bassi C, Butturini G, Falconi M, et al. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma. Br J Surg 2003;90:555–559

    Article  PubMed  CAS  Google Scholar 

  30. Hirota T, Tomida T, Iwasa M, et al. Solitary pancreatic metastasis occurring eight years after nephrectomy for renal carcinoma. A case report and surgical review. Int J Pancreatol 1996;19:145–153

    PubMed  CAS  Google Scholar 

  31. Kavolius JP, Mastorakos DP, Pavlovich C, et al. Resection of metastatic renal cell carcinoma. J Clin Oncol 1998;16:2261–2266

    PubMed  CAS  Google Scholar 

  32. Tuech JJ, Pessaux P, Chautard D, et al. Results of duodenopancreatectomy for solitary pancreatic metastasis from renal cell carcinoma. J Hepatobiliary Pancreat Surg 1999;6:396–398

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Milan Bicocca, San Gerardo Hospital, Via Donizetti, 106, 20052, Monza, MI, Italy

    Stefano Crippa MD, Carlo Angelini MD, Chiara Mussi, Fabrizio Romano MD, Paola Sartori MD & Franco Uggeri MD

  2. Department of Gynaecology, University of Milan Bicocca, San Gerardo Hospital, Via Donizetti, 106, 20052, Monza, Italy

    Claudia Bonardi MD

  3. Department of Pathology, University of Milan Bicocca, San Gerardo Hospital, Via Donizetti, 106, 20052, Monza, Italy

    Giorgio Bovo MD

  4. Via Grandi, 8, 20059, Vimercate, MI, Italy

    Stefano Crippa MD

Authors
  1. Stefano Crippa MD
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  2. Carlo Angelini MD
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  3. Chiara Mussi
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  4. Claudia Bonardi MD
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  5. Fabrizio Romano MD
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  6. Paola Sartori MD
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  7. Franco Uggeri MD
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  8. Giorgio Bovo MD
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Correspondence to Stefano Crippa MD.

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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. 30, 1536–1542 (2006). https://doi.org/10.1007/s00268-005-0464-4

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  • DOI: https://doi.org/10.1007/s00268-005-0464-4

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