Pancreatic resections for advanced M1-pancreatic carcinoma: the value of synchronous metastasectomy

Background. For M1 pancreatic adenocarcinomas pancreatic resection is usually not indicated. However, in highly selected patients synchronous metastasectomy may be appropriate together with pancreatic resection when oper
Background. For M1 pancreatic adenocarcinomas pancreatic resection is usually not indicated. However, in highly selected patients synchronous metastasectomy may be appropriate together with pancreatic resection when operative morbidity is low. 

Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological  parameters were evaluated. 

Results. There were 20 patients (9 men, 11 women; mean age 58 years) identified. The primary tumor was located in the  pancreatic head (n=9, 45%), in pancreatic tail (n=9, 45%), and in the papilla Vateri (n=2, 10%). Metastases were located in the liver (n=14, 70%), peritoneum (n=5, 25%), and omentum majus (n=2, 10%). Lymphnode metastases were present in 16 patients (80%). All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months) which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; =.1). 

Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.
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Metadaten
Author:Stefanie Katharina Seelig, Björn Burkert, Ansgar Michael Chromik, Andrea Tannapfel, Waldemar Uhl, Mathias H. Seelig
URN:urn:nbn:de:hebis:30:3-250128
DOI:http://dx.doi.org/doi:10.1155/2010/579672
ISSN:1607-8462
ISSN:0894-8569
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=21197481
Parent Title (English):HPB surgery
Publisher:Hindawi
Place of publication:New York, NY
Document Type:Article
Language:English
Date of Publication (online):2010/10/14
Date of first Publication:2010/10/14
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2012/06/01
Volume:Volume 2010 (2010)
Issue:Article ID 579672
Pagenumber:6
First Page:1
Last Page:6
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 3.0

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