Yuki Homma1, Itaru Endo1, Ryusei Matsuyama1, Masayuki Sho2, Shugo Mizuno3, Yasuji Seyama4, Satoshi Hirano5, Takashi Aono6, Chie Kitami7, Yoshifumi Morita8, Yutaka Takeda9, Kazuhiro Yoshida10, Masaji Tani11, Takashi Kaiho12, Yuzo Yamamoto13, Hideki Aoki14, Masao Ogawa15, Takefumi Niguma16, Yuko Mataki17, Hiroshi Kawasaki18, Hideo Baba19, Hiroshi Yokomizo20, Toshiki Rikiyama21, Hiroki Yamaue22, Masakazu Yamamoto23. 1. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama City, Japan. 2. Department of Surgery, Nara Medical University, Kashihara City, Japan. 3. Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu City, Japan. 4. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Japan. 5. Department of Gastroenterological Surgery Ⅱ, Faculty of Medicine, Hokkaido University, Sapporo City, Japan. 6. Department of Surgery, Niigata Prefectural Central Hospital, Joetsu City, Japan. 7. Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka City, Japan. 8. Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan. 9. Department of Surgery, Kansai Rosai Hospital, Amagasaki City, Japan. 10. Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu City, Japan. 11. Department of Surgery, Shiga University of Medical Science, Otsu City, Japan. 12. Department of Surgery, Kimitsu Chuo Hospital, Kisarazu City, Japan. 13. Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita City, Japan. 14. Department of Surgery, Iwakuni Medical Center, Iwakuni City, Japan. 15. Department of Surgery, Bell Land General Hospital, Sakai City, Japan. 16. Department of Surgery, Okayama Saiseikai General Hospital, Okayama City, Japan. 17. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima City, Japan. 18. Department of Surgery, Ibaraki Prefectural Central Hospital, Kasama City, Japan. 19. Department of Gastroenterological Surgery, Kumamoto University, Kumamoto City, Japan. 20. Department of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto City, Japan. 21. Department of Surgery, Saitama Medical Center, Jichi Medical University, Sitama City, Japan. 22. 2nd Department of Surgery, Wakayama Medical University, Wakayama City, Wakayama, Japan. 23. Department of Surgery, Institute of Gastroenterology, Tokyo Women`s Medical University, Tokyo, Japan.
Abstract
BACKGROUND: Although distant metastasis from pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, some single center studies reported that lung metastasis has a favorable prognosis. The aim of this study is to evaluate the prognostic value of site-specific metastasis after pancreatectomy for PDAC, with a focus on lung metastasis. METHODS: Data from 117 cases of lung metastasis after pancreatectomy were collected retrospectively from 23 institutions in Japan. To compare the sites of metastasis we also collected the data of 134 patients with liver only metastasis, 67 patients with peritoneal only metastasis and 121 patients with locoregional recurrence alone. RESULTS: In patients with lung only metastasis, the median time from recurrence to death (RTD) was 23.1 months, which was better in comparison to other sites of recurrence. In lung metastasis group, the patients who underwent pulmonary resection had better long-term outcomes in comparison to those who did not. (RTD: 29.2 vs 15.2, P < .001). In the multivariate analysis, solitary metastasis (HR 5.03; 95% CI 1.195-21.144, P = .022) and postoperative chemotherapy (HR 14.089; 95% CI 1.729-114.77, P = .023) were identified as significant prognostic factors after lung resection. CONCLUSIONS: Surgical resection is a favorable option for selected patients with a solitary lung metastasis and for whom adjuvant chemotherapy can be administrated.
BACKGROUND: Although distant metastasis from pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, some single center studies reported that lung metastasis has a favorable prognosis. The aim of this study is to evaluate the prognostic value of site-specific metastasis after pancreatectomy for PDAC, with a focus on lung metastasis. METHODS: Data from 117 cases of lung metastasis after pancreatectomy were collected retrospectively from 23 institutions in Japan. To compare the sites of metastasis we also collected the data of 134 patients with liver only metastasis, 67 patients with peritoneal only metastasis and 121 patients with locoregional recurrence alone. RESULTS: In patients with lung only metastasis, the median time from recurrence to death (RTD) was 23.1 months, which was better in comparison to other sites of recurrence. In lung metastasis group, the patients who underwent pulmonary resection had better long-term outcomes in comparison to those who did not. (RTD: 29.2 vs 15.2, P < .001). In the multivariate analysis, solitary metastasis (HR 5.03; 95% CI 1.195-21.144, P = .022) and postoperative chemotherapy (HR 14.089; 95% CI 1.729-114.77, P = .023) were identified as significant prognostic factors after lung resection. CONCLUSIONS: Surgical resection is a favorable option for selected patients with a solitary lung metastasis and for whom adjuvant chemotherapy can be administrated.
Authors: Haitao Gu; Wensheng Deng; Yi Zhang; Yu Chang; Vishal G Shelat; Kunihiro Tsuchida; Leonardo S Lino-Silva; Zhaowen Wang Journal: Transl Lung Cancer Res Date: 2022-05