Takashi Ito, Ryoji Takada1, Shunsuke Omoto2, Motoyuki Tsuda3, Daisuke Masuda4, Hironari Kato5, Toshihiko Matsumoto6, Ichiro Moriyama7, Yoshinobu Okabe8, Hideyuki Shiomi9, Etsuji Ishida10, Keiichi Hatamaru11, Shinichi Hashimoto12, Kiyohito Tanaka13, Hirofumi Kawamoto14, Akio Yanagisawa15, Toshiro Katayama16, Shujiro Yazumi. 1. Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Japan. 2. Department of Gastroenterology and Hepatology, Kindai University Faculty Medicine, Osaka-Sayama, Japan. 3. Department of Gastroenterology and Hepatology, Graduate School of Medicine Kyoto University, Kyoto, Japan. 4. 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan. 5. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 6. Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan. 7. Department of Hematology/Oncology, Shimane University Hospital, Shimane, Japan. 8. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan. 9. Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan. 10. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan. 11. Department of Gastroenterology and Hepatology, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan. 12. Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 13. Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan. 14. Department of Internal Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan. 15. Department of Surgical Pathology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan. 16. Faculty of Medical Engineering, Himeji Dokkyo University School of Health Care Sciences, Himeji, Japan.
Abstract
OBJECTIVES: Pancreatic metastases (PMs) account for 1% to 2% of pancreatic tumors, and their prognostic significance is poorly defined. We evaluated the incidence and clinical characteristics of primary tumors and defined prognostic factors. METHODS: This retrospective study of 39 Japanese tertiary referral hospitals (January 2005 to August 2015) analyzed patient and tumor characteristics and survival time. Kaplan-Meier analysis and Cox proportional hazards models were applied to evaluate overall survival and prognostic factors, respectively. RESULTS: We enrolled 159 patients with a pathologic diagnosis of PM. The most common primary tumor was renal cell carcinoma (38.4%), followed by lung cancer (24.5%), colorectal cancer (11.3%), and sarcoma (6.3%). Eight patients were lost during follow-up, and 151 patients were included for statistical analysis. Median overall survival was 43.0 months, and the 5-year survival rate was 42.6%. Multivariate analysis identified 3 independent prognostic factors: extrapancreatic metastasis (hazard ratio, 2.13; 95% confidence interval, 1.11-4.07; P = 0.02), tumor-related symptoms at diagnosis (hazard ratio, 5.39; 95% confidence interval, 2.92-9.91; P < 0.001), and pathologic diagnosis of primary tumors (P < 0.001). CONCLUSIONS: Treatment strategies and prognoses for PMs completely differ according to the primary tumor type. A definitive pathologic diagnosis of PMs is essential for selecting the appropriate treatment.
OBJECTIVES:Pancreatic metastases (PMs) account for 1% to 2% of pancreatic tumors, and their prognostic significance is poorly defined. We evaluated the incidence and clinical characteristics of primary tumors and defined prognostic factors. METHODS: This retrospective study of 39 Japanese tertiary referral hospitals (January 2005 to August 2015) analyzed patient and tumor characteristics and survival time. Kaplan-Meier analysis and Cox proportional hazards models were applied to evaluate overall survival and prognostic factors, respectively. RESULTS: We enrolled 159 patients with a pathologic diagnosis of PM. The most common primary tumor was renal cell carcinoma (38.4%), followed by lung cancer (24.5%), colorectal cancer (11.3%), and sarcoma (6.3%). Eight patients were lost during follow-up, and 151 patients were included for statistical analysis. Median overall survival was 43.0 months, and the 5-year survival rate was 42.6%. Multivariate analysis identified 3 independent prognostic factors: extrapancreatic metastasis (hazard ratio, 2.13; 95% confidence interval, 1.11-4.07; P = 0.02), tumor-related symptoms at diagnosis (hazard ratio, 5.39; 95% confidence interval, 2.92-9.91; P < 0.001), and pathologic diagnosis of primary tumors (P < 0.001). CONCLUSIONS: Treatment strategies and prognoses for PMs completely differ according to the primary tumor type. A definitive pathologic diagnosis of PMs is essential for selecting the appropriate treatment.