Surgical treatment of metastatic tumors to the pancreas: A single center experience and review of the literature

Stefano Crippa, Carlo Angelini, Chiara Mussi, Claudia Bonardi, Fabrizio Romano, Paola Sartori, Franco Uggeri, Giorgio Bovo

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Background: Unlike primary pancreatic carcinoma, metastases to the pancreas are rare, and their resection may be performed as palliative treatment. The aim of this study was to review our experience with the operative management of pancreatic metastases. Materials and Methods: Between January 1994 and December 2004 13 patients (nine women and four men; median age: 59 years; range: 36-79 years) were admitted to our institution with metastatic lesion to the pancreas. The clinical features of the treatment and results were examined. Results: Primary tumors were renal cell carcinoma (n = 5), lobular carcinoma of the breast (n = 3), endometrioid carcinoma of the ovary (n = 1), colonic adenocarcinoma (n = 1), jejunal leiomyosarcoma (n = 1), melanoma (n = 1), and non-small-cell lung cancer (n = 1). The median interval between primary tumor and pancreatic metastases was 36 months (range: 5-192 months). Six patients (46%) were asymptomatic, while the other seven patients presented with jaundice, pain, and duodenal obstruction. Two patients with extrapancreatic disease underwent palliative surgery, and the remaining 11 patients underwent operative procedures that included seven pancreaticoduodenectomy and four distal pancreatectomies with splenectomy. Postoperative mortality was nil, and the morbidity rate was 30%. The two patients who underwent palliative surgery died after 7 and 9 months, respectively. The median survival of the resected patients was 26 months (range: 13-95 months). Five patients died of disease, eight are alive at the time of this report. Conclusion: A trend towards improved survival, even if not statistically significant, was observed in the renal carcinoma patients reported here. Surgical resection can be performed safely in selected patients with isolated metastases to the pancreas, achieving long-term survival as well as good palliation.

Original languageEnglish
Pages (from-to)1536-1542
Number of pages7
JournalWorld Journal of Surgery
Volume30
Issue number8
DOIs
Publication statusPublished - Aug 2006

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Pancreas
Neoplasms
Palliative Care
Neoplasm Metastasis
Therapeutics
Survival
Duodenal Obstruction
Endometrioid Carcinoma
Lobular Carcinoma
Pancreatectomy
Pancreaticoduodenectomy
Leiomyosarcoma
Operative Surgical Procedures
Splenectomy
Jaundice
Renal Cell Carcinoma
Non-Small Cell Lung Carcinoma
Ovary
Melanoma
Adenocarcinoma

ASJC Scopus subject areas

  • Surgery

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Surgical treatment of metastatic tumors to the pancreas : A single center experience and review of the literature. / Crippa, Stefano; Angelini, Carlo; Mussi, Chiara; Bonardi, Claudia; Romano, Fabrizio; Sartori, Paola; Uggeri, Franco; Bovo, Giorgio.

In: World Journal of Surgery, Vol. 30, No. 8, 08.2006, p. 1536-1542.

Research output: Contribution to journalArticle

Crippa, Stefano ; Angelini, Carlo ; Mussi, Chiara ; Bonardi, Claudia ; Romano, Fabrizio ; Sartori, Paola ; Uggeri, Franco ; Bovo, Giorgio. / Surgical treatment of metastatic tumors to the pancreas : A single center experience and review of the literature. In: World Journal of Surgery. 2006 ; Vol. 30, No. 8. pp. 1536-1542.
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abstract = "Background: Unlike primary pancreatic carcinoma, metastases to the pancreas are rare, and their resection may be performed as palliative treatment. The aim of this study was to review our experience with the operative management of pancreatic metastases. Materials and Methods: Between January 1994 and December 2004 13 patients (nine women and four men; median age: 59 years; range: 36-79 years) were admitted to our institution with metastatic lesion to the pancreas. The clinical features of the treatment and results were examined. Results: Primary tumors were renal cell carcinoma (n = 5), lobular carcinoma of the breast (n = 3), endometrioid carcinoma of the ovary (n = 1), colonic adenocarcinoma (n = 1), jejunal leiomyosarcoma (n = 1), melanoma (n = 1), and non-small-cell lung cancer (n = 1). The median interval between primary tumor and pancreatic metastases was 36 months (range: 5-192 months). Six patients (46{\%}) were asymptomatic, while the other seven patients presented with jaundice, pain, and duodenal obstruction. Two patients with extrapancreatic disease underwent palliative surgery, and the remaining 11 patients underwent operative procedures that included seven pancreaticoduodenectomy and four distal pancreatectomies with splenectomy. Postoperative mortality was nil, and the morbidity rate was 30{\%}. The two patients who underwent palliative surgery died after 7 and 9 months, respectively. The median survival of the resected patients was 26 months (range: 13-95 months). Five patients died of disease, eight are alive at the time of this report. Conclusion: A trend towards improved survival, even if not statistically significant, was observed in the renal carcinoma patients reported here. Surgical resection can be performed safely in selected patients with isolated metastases to the pancreas, achieving long-term survival as well as good palliation.",
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AU - Angelini, Carlo

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AU - Romano, Fabrizio

AU - Sartori, Paola

AU - Uggeri, Franco

AU - Bovo, Giorgio

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N2 - Background: Unlike primary pancreatic carcinoma, metastases to the pancreas are rare, and their resection may be performed as palliative treatment. The aim of this study was to review our experience with the operative management of pancreatic metastases. Materials and Methods: Between January 1994 and December 2004 13 patients (nine women and four men; median age: 59 years; range: 36-79 years) were admitted to our institution with metastatic lesion to the pancreas. The clinical features of the treatment and results were examined. Results: Primary tumors were renal cell carcinoma (n = 5), lobular carcinoma of the breast (n = 3), endometrioid carcinoma of the ovary (n = 1), colonic adenocarcinoma (n = 1), jejunal leiomyosarcoma (n = 1), melanoma (n = 1), and non-small-cell lung cancer (n = 1). The median interval between primary tumor and pancreatic metastases was 36 months (range: 5-192 months). Six patients (46%) were asymptomatic, while the other seven patients presented with jaundice, pain, and duodenal obstruction. Two patients with extrapancreatic disease underwent palliative surgery, and the remaining 11 patients underwent operative procedures that included seven pancreaticoduodenectomy and four distal pancreatectomies with splenectomy. Postoperative mortality was nil, and the morbidity rate was 30%. The two patients who underwent palliative surgery died after 7 and 9 months, respectively. The median survival of the resected patients was 26 months (range: 13-95 months). Five patients died of disease, eight are alive at the time of this report. Conclusion: A trend towards improved survival, even if not statistically significant, was observed in the renal carcinoma patients reported here. Surgical resection can be performed safely in selected patients with isolated metastases to the pancreas, achieving long-term survival as well as good palliation.

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