[The treatments of hepatic metastasis from pancreato-biliary cancer].

Hepatic metastases of pancreatobiliary cancer have a dismal patient prognosis of approximately 1 year after diagnosis. There have been a few reports in the literature on aggressive treatment of these patients with the intention of cure. For hepatic metastases from biliary cancer, hepatic resection has been performed in a small number of patients, resulting in a median survival time of less than 12 months. In our series of 7 patients, median survival time was 9 months. For hepatic metastases of gallbladder carcinoma, long-term (> 3-year) survivors have been reported. In our series of 16 patients, median survival time was 8 months, but one patient is still alive after more than 5 years. For simultaneous hepatic metastases of pancreas cancer. Howard et al and Takada et al have reported the results of aggressive surgical resection in 10 and 11 consecutive patients, respectively. The median survival times in their series were 11 and 6 months after hepatic resection and pancreaticoduodenectomy, respectively. These results cannot justify aggressive resection for patients with hepatic metastases of pancreatic cancer. In most series previously reported, the treatment for hepatic metastases from pancreatobiliary malignancies was systemic and regional chemotherapy, especially hepatic arterial infusion chemotherapy. However, there is no evidence suggesting a beneficial effect of cancer chemotherapy on prognosis. Therefore new therapeutic modalities should be developed to improve the outcome of the treatment of hepatic metastases of pancreatobiliary cancer.