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Annals of Surgical Oncology

Open Access 19-03-2024 | Metastasis | Hepatobiliary Tumors

Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability

Authors: Shruti Koti, MD, Lyudmyla Demyan, MD, Gary Deutsch, MD, MPH, Matthew Weiss, MD, MBA

Published in: Annals of Surgical Oncology

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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is most often metastatic at diagnosis. As systemic therapy continues to improve alongside advanced surgical techniques, the focus has shifted toward defining biologic, rather than technical, resectability. Several centers have reported metastasectomy for oligometastatic PDAC, yet the indications and potential benefits remain unclear. In this review, we attempt to define oligometastatic disease in PDAC and to explore the rationale for metastasectomy. We evaluate the existing evidence for metastasectomy in liver, peritoneum, and lung individually, assessing the safety and oncologic outcomes for each. Furthermore, we explore contemporary biomarkers of biological resectability in oligometastatic PDAC, including radiographic findings, biochemical markers (such as CA 19-9 and CEA), inflammatory markers (including neutrophil-to-lymphocyte ratio, C-reactive protein, and scoring indices), and liquid biopsy techniques. With careful consideration of existing data, we explore the concept of biologic resectability in guiding patient selection for metastasectomy in PDAC.
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Metadata
Title
Surgery for Oligometastatic Pancreatic Cancer: Defining Biologic Resectability
Authors
Shruti Koti, MD
Lyudmyla Demyan, MD
Gary Deutsch, MD, MPH
Matthew Weiss, MD, MBA
Publication date
19-03-2024
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-15129-8