Outcome After Surgical Resection of Isolated Metastases to the Pancreas

Background/aims: The pancreas is an unusual site for metastases. Thus, the efficacy of pancreatic resection in patients with metastatic pancreas cancer remains unclear. This study examined the result of surgical resection for patients with pancreatic metastases.

Methodology: A retrospective analysis was undertaken of fifteen patients subjected to surgical resection of pancreatic metastases from January 1983 to September 2008.

Results: The median disease-free interval between the primary and metastatic cancer was 59 months (range, 0-180 months). Median survival of the 15 patients was 31 months (95% CI, 26-35 months). The primary histopathology was renal cell carcinoma (RCC) (n=7, 47%), colorectal cancer (n=3), breast cancer (n=1), non-small-cell lung cancer (n=1), ovarian cancer (n=1), cervical cancer (n=l), or leiomyosarcoma (n=1). Surgical procedures included pancreaticoduodenectomy (n=6), distal pancreatectomy (n=8), and medial pancreatectomy followed by total pancreatectomy (n=1). Median survival after pancreatectomy was 45 months in patients with RCC and 31 months in those with non-RCC as primary cancer (p = 0.49).

Conclusion: Surgical resection is the treatment of choice for maximizing long-term survival in patients with pancreatic metastases from RCC. However, resection of pancreatic metastases from non-RCC patients carries a poor prognosis, and pancreatectomy is probably not warranted.