Surgical and Local Treatment of Hepatic Metastasis in Pancreatic Ductal Adenocarcinoma: Recent Advances and Future Prospects

Overview

Journal Ther Adv Med Oncol

Specialty Oncology

Date 2020 Jul 9

PMID 32636941

Citations 9

Authors

Tianqiang Jin

Chaoliu Dai

Feng Xu

Affiliations

Soon will be listed here.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with increasing incidence and mortality. More than half of PDAC patients develop metastases, with the liver being the most common site. Patients with pancreatic ductal adenocarcinoma with liver metastases (PCLM) have a very limited scope for surgery due to aggressive tumor behavior and poor prognosis. However, with the improvements in preoperative systemic therapy and perioperative outcomes, an increasing number of patients are being considered for surgical management. However, the best choice of surgical treatment and criteria for selecting suitable PCLM patients who may benefit from surgical treatment remains controversial. Palliative local treatments, such as ablation, locoregional chemotherapy, and brachytherapy, which are less invasive and have fewer contraindications and complications, are the preferred alternatives to surgery. The present study reviews the advances in the management of PCLM, with focus on resection and local therapies.

Citing Articles

Reprogramming tumor-associated macrophages with lipid nanosystems reduces PDAC tumor burden and liver metastasis.

Palencia-Campos A, Ruiz-Canas L, Abal-Sanisidro M, Lopez-Gil J, Batres-Ramos S, Saraiva S J Nanobiotechnology. 2024; 22(1):795.

PMID: 39719597 PMC: 11668009. DOI: 10.1186/s12951-024-03010-5.

Small cell lung cancer with liver metastases: from underlying mechanisms to treatment strategies.

Fan L, Lin Y, Fu Y, Wang J Cancer Metastasis Rev. 2024; 44(1):5.

PMID: 39585433 DOI: 10.1007/s10555-024-10220-8.

A pancreatic adenocarcinoma mimicking hepatoid carcinoma of uncertain histogenesis: A case report and literature review.

Iliesiu A, Toma R, Ciongariu A, Costea R, Zarnescu N, Bilteanu L Oncol Lett. 2023; 26(4):442.

PMID: 37720666 PMC: 10502951. DOI: 10.3892/ol.2023.14029.

Increased Levels of miR-15b-5p and miR-20b-5p in Pancreatic Ductal Adenocarcinoma with Hepatic Metastases.

Dobre M, Poenaru R, Niculae A, Vladut C, Herlea V, Milanesi E Genes (Basel). 2023; 14(8).

PMID: 37628628 PMC: 10454474. DOI: 10.3390/genes14081577.

Pancreatic ductal adenocarcinoma with synchronous and metachronous hepatic metastasis predicted by contrast-enhanced ultrasound.

Jia W, Gui Y, Chen X, Tan L, Zhang J, Xiao M Quant Imaging Med Surg. 2023; 13(6):3902-3914.

PMID: 37284072 PMC: 10240015. DOI: 10.21037/qims-22-1132.

References

Vogl T, Mohamed S, Albrecht M, Gruber-Roh T, Lin H, Nour Eldin N . Transarterial chemoembolization in pancreatic adenocarcinoma with liver metastases: MR-based tumor response evaluation, apparent diffusion coefficient (ADC) patterns, and survival rates. Pancreatology. 2017; 18(1):94-99. DOI: 10.1016/j.pan.2017.11.014. View

Neofytou K, Giakoustidis A, Smyth E, Cunningham D, Mudan S . A case of metastatic pancreatic adenocarcinoma with prolonged survival after combination of neoadjuvant FOLFIRINOX therapy and synchronous distal pancreatectomy and hepatectomy. J Surg Oncol. 2015; 111(6):768-70. DOI: 10.1002/jso.23867. View

Conroy T, Desseigne F, Ychou M, Bouche O, Guimbaud R, Becouarn Y . FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011; 364(19):1817-25. DOI: 10.1056/NEJMoa1011923. View

Hackert T, Niesen W, Hinz U, Tjaden C, Strobel O, Ulrich A . Radical surgery of oligometastatic pancreatic cancer. Eur J Surg Oncol. 2016; 43(2):358-363. DOI: 10.1016/j.ejso.2016.10.023. View

Shi H, Jin C, Fu D . Preoperative evaluation of pancreatic ductal adenocarcinoma with synchronous liver metastasis: Diagnosis and assessment of unresectability. World J Gastroenterol. 2016; 22(45):10024-10037. PMC: 5143749. DOI: 10.3748/wjg.v22.i45.10024. View

Bellon E, Gebauer F, Tachezy M, Izbicki J, Bockhorn M . Pancreatic cancer and liver metastases: state of the art. Updates Surg. 2016; 68(3):247-251. DOI: 10.1007/s13304-016-0407-7. View

Klein F, Puhl G, Guckelberger O, Pelzer U, Pullankavumkal J, Guel S . The impact of simultaneous liver resection for occult liver metastases of pancreatic adenocarcinoma. Gastroenterol Res Pract. 2012; 2012:939350. PMC: 3508736. DOI: 10.1155/2012/939350. View

Yamada S, Fujii T, Sugimoto H, Kanazumi N, Kasuya H, Nomoto S . Pancreatic cancer with distant metastases: a contraindication for radical surgery?. Hepatogastroenterology. 2009; 56(91-92):881-5. View

Martin 2nd R, Kwon D, Chalikonda S, Sellers M, Kotz E, Scoggins C . Treatment of 200 locally advanced (stage III) pancreatic adenocarcinoma patients with irreversible electroporation: safety and efficacy. Ann Surg. 2015; 262(3):486-94. DOI: 10.1097/SLA.0000000000001441. View

10.

Li D, Xie K, Wolff R, Abbruzzese J . Pancreatic cancer. Lancet. 2004; 363(9414):1049-57. DOI: 10.1016/S0140-6736(04)15841-8. View

11.

Sun J, Zhou T, Zhang Y, Zhou G, Nie C, Zhu T . Efficacy of transcatheter arterial chemoembolization for liver metastases arising from pancreatic cancer. Oncotarget. 2017; 8(24):39746-39755. PMC: 5503649. DOI: 10.18632/oncotarget.14642. View

12.

Schneitler S, Kropil P, Riemer J, Antoch G, Knoefel W, Haussinger D . Metastasized pancreatic carcinoma with neoadjuvant FOLFIRINOX therapy and R0 resection. World J Gastroenterol. 2015; 21(20):6384-90. PMC: 4445117. DOI: 10.3748/wjg.v21.i20.6384. View

13.

Ghaneh P, Costello E, Neoptolemos J . Biology and management of pancreatic cancer. Postgrad Med J. 2008; 84(995):478-97. DOI: 10.1136/gut.2006.103333. View

14.

Huang J, Hernandez-Alejandro R, Croome K, Yan L, Wu H, Chen Z . Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1,061 cases. J Gastrointest Surg. 2010; 15(2):311-20. DOI: 10.1007/s11605-010-1372-y. View

15.

Frigerio I, Regi P, Giardino A, Scopelliti F, Girelli R, Bassi C . Downstaging in Stage IV Pancreatic Cancer: A New Population Eligible for Surgery?. Ann Surg Oncol. 2017; 24(8):2397-2403. DOI: 10.1245/s10434-017-5885-4. View

16.

Yang J, Zhang J, Lui W, Huo Y, Fu X, Yang M . Patients with hepatic oligometastatic pancreatic body/tail ductal adenocarcinoma may benefit from synchronous resection. HPB (Oxford). 2019; 22(1):91-101. DOI: 10.1016/j.hpb.2019.05.015. View

17.

Gibbs P, Do C, Lipton L, Cade D, Tapner M, Price D . Phase II trial of selective internal radiation therapy and systemic chemotherapy for liver-predominant metastases from pancreatic adenocarcinoma. BMC Cancer. 2015; 15:802. PMC: 4624193. DOI: 10.1186/s12885-015-1822-8. View

18.

Akgul O, Cetinkaya E, Ersoz S, Tez M . Role of surgery in colorectal cancer liver metastases. World J Gastroenterol. 2014; 20(20):6113-22. PMC: 4033450. DOI: 10.3748/wjg.v20.i20.6113. View

19.

Shi S, Yu X . Time to think: Selecting patients who may benefit from synchronous resection of primary pancreatic cancer and liver metastases. World J Gastroenterol. 2018; 24(33):3677-3680. PMC: 6127654. DOI: 10.3748/wjg.v24.i33.3677. View

20.

Michl M, Haug A, Jakobs T, Paprottka P, Hoffmann R, Bartenstein P . Radioembolization with Yttrium-90 microspheres (SIRT) in pancreatic cancer patients with liver metastases: efficacy, safety and prognostic factors. Oncology. 2014; 86(1):24-32. DOI: 10.1159/000355821. View