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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2019

01-06-2019 | Metastasis | Pancreatic Tumors

Surgical Resection for Metastatic Tumors in the Pancreas: A Single-Center Experience and Systematic Review

Authors: Qiuyi Huang, MD, Haiyang Zhou, MD, Chen Liu, MD, Kaizhou Jin, MD, Kun Fan, MD, He Cheng, MD, Zhiyao Fan, MD, Chao Yang, MD, Liang Liu, MD, Jiang Long, MD, Jin Xu, MD, Quanxing Ni, MD, Zhiqian Hu, MD, Xianjun Yu, MD

Published in: Annals of Surgical Oncology | Issue 6/2019

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Abstract

Background

Metastatic lesion to the pancreas accounts for approximately 2% of pancreatic neoplasms. There is no prospective, randomized or case-controlled study evaluating the role of pancreatic metastasectomy.

Methods

The PubMed, EMBASE, and Cochrane Library electronic databases were searched for studies published between January 1, 2001 and December 31, 2017. Studies with five or more patients who received pancreatic metastasectomy and data from our institution (29 patients) were included. The Kaplan–Meier method was used for survival analysis.

Results

A total of 414 patients from 20 institutions who underwent pancreatic resections were included. Of the reported 31 kinds of primary neoplasms, renal-cell carcinoma (RCC) comprised the most (54.3%). At the time of diagnosis, although 40.3% patients were asymptomatic, abdominal pain (34.8%) and jaundice (20.6%) were relatively common. As for surgical type, pancreatoduodenectomy, total pancreatectomy, distal pancreatectomy, and enucleation took up 37.9%, 11.4%, 43.5%, and 7.2% respectively. The mortality and morbidity rates were 1.4% and 48.3% respectively. Patients with symptoms at the time of diagnosis had significantly shorter survival compared with asymptomatic patients (p = 0.017). Those with RCC as primary tumor had significantly longer survival compared with non-RCC patients (p < 0.001). Positive margin also predicts worse prognosis (p = 0.035).

Conclusions

Pancreatic metastasectomy is safe and associated with acceptable short- and intermediate-term results. In the conditions of RCC as the primary tumor, being asymptomatic, or negative resection margin, a better prognosis after resection can be achieved.
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Metadata
Title
Surgical Resection for Metastatic Tumors in the Pancreas: A Single-Center Experience and Systematic Review
Authors
Qiuyi Huang, MD
Haiyang Zhou, MD
Chen Liu, MD
Kaizhou Jin, MD
Kun Fan, MD
He Cheng, MD
Zhiyao Fan, MD
Chao Yang, MD
Liang Liu, MD
Jiang Long, MD
Jin Xu, MD
Quanxing Ni, MD
Zhiqian Hu, MD
Xianjun Yu, MD
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07258-2

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