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Long-Term Outcomes of 98 Surgically Resected Metastatic Tumors in the Pancreas

Shin-Rong Lee MD, PhD, Georgios Gemenetzis MD, Michol Cooper MD, PhD, Ammar A. Javed MD, John L. Cameron MD, Christopher L. Wolfgang MD, PhD, Frederick E. Eckhauser MD, Jin He MD, PhD, Matthew J. Weiss MD
Pancreatic Tumors
Volume 24, Issue 3 / March , 2017

Abstract

Purpose

The goal of this study was to assess the outcomes and characteristics of patients who underwent pancreatectomy for metastatic disease to the pancreas.

Methods

Patients who underwent surgical resection of metastatic disease to the pancreas from 1988 to 2016 were identified using a prospectively maintained database. Data on clinicopathological features and outcomes of these patients were analyzed. Cox proportional hazard models were employed to identify patient-specific risk factors that influence survival.

Results

Ninety-seven patients underwent 98 pancreatic metastasectomies from July 1988 through March 2016 for metastatic disease from 13 different primary cancers. Pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy were performed in 49 (50 %), 37 (38 %), and 12 (12 %) patients, respectively. Postoperative complications occurred in 55 (56 %) patients, while 3 (3 %) perioperative deaths occurred. Median follow-up was 2.0 years, with a median survival of 3.2 years. Multivariate analysis revealed that older patients [hazard ratio (HR) 1.04/year; p = 0.006], non-renal cell carcinomas (HR 5.07; p < 0.001), vascular invasion (HR 3.53; p < 0.001), and positive resection margins (HR 2.62; p = 0.008) were independently associated with an increased risk of mortality.

Conclusions

Pancreatic metastasectomy is safe and feasible in well-selected patients and is associated with acceptable long-term survival.

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