BACKGROUND: Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. STUDY DESIGN: Retrospective review of all pancreatic resections between January 1993 and October 2009. RESULTS: We identified 40 patients with a median age of 62 years; 55% were female. Patients most commonly presented with abdominal pain (47.5%). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61%. For RCCs, pancreas was the first site of an extrarenal recurrence in 85% and was synchronous with the primary in 5% of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. CONCLUSIONS: An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.
BACKGROUND:Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. STUDY DESIGN: Retrospective review of all pancreatic resections between January 1993 and October 2009. RESULTS: We identified 40 patients with a median age of 62 years; 55% were female. Patients most commonly presented with abdominal pain (47.5%). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61%. For RCCs, pancreas was the first site of an extrarenal recurrence in 85% and was synchronous with the primary in 5% of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. CONCLUSIONS: An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.
Authors: Paul M Magtibay; Peter B Adams; M Bradley Silverman; Stephen S Cha; Karl C Podratz Journal: Gynecol Oncol Date: 2006-04-24 Impact factor: 5.482
Authors: Claudio Bassi; Christos Dervenis; Giovanni Butturini; Abe Fingerhut; Charles Yeo; Jakob Izbicki; John Neoptolemos; Michael Sarr; William Traverso; Marcus Buchler Journal: Surgery Date: 2005-07 Impact factor: 3.982
Authors: Eric L Eisenhauer; Nadeem R Abu-Rustum; Yukio Sonoda; Douglas A Levine; Elizabeth A Poynor; Carol Aghajanian; William R Jarnagin; Ronald P DeMatteo; Michael I D'Angelica; Richard R Barakat; Dennis S Chi Journal: Gynecol Oncol Date: 2006-08-04 Impact factor: 5.482
Authors: Michael A Choti; James V Sitzmann; Marcelo F Tiburi; Wuthi Sumetchotimetha; Ram Rangsin; Richard D Schulick; Keith D Lillemoe; Charles J Yeo; John L Cameron Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: Tarek M Mekhail; Rony M Abou-Jawde; Gabriel Boumerhi; Sareena Malhi; Laura Wood; Paul Elson; Ronald Bukowski Journal: J Clin Oncol Date: 2005-02-01 Impact factor: 44.544
Authors: Roberto Ballarin; Mario Spaggiari; Nicola Cautero; Nicola De Ruvo; Roberto Montalti; Cristina Longo; Anna Pecchi; Patrizia Giacobazzi; Giuseppina De Marco; Giuseppe D'Amico; Giorgio Enrico Gerunda; Fabrizio Di Benedetto Journal: World J Gastroenterol Date: 2011-11-21 Impact factor: 5.742
Authors: Andrea Anderloni; Marco Ballarè; Michela Pagliarulo; Marco Orsello; Antonio Ramponi; Mario Del Piano Journal: J Gastrointest Oncol Date: 2013-12
Authors: Andrew P Loehrer; David C Chang; Matthew M Hutter; Zirui Song; Keith D Lillemoe; Andrew L Warshaw; Cristina R Ferrone Journal: J Am Coll Surg Date: 2015-10-09 Impact factor: 6.113