Curative-intent pancreas resection for pancreatic metastases: surgical and oncological results
Curative-intent pancreas resection for pancreatic metastases: surgical and oncological results
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DOI：
10.1007/s10585-020-10029-z
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发表时间：
2020-02-24
影响因子：
4
通讯作者：
Wittel, Uwe A.
中科院分区：
文献类型：
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作者：
Chikhladze, Sophia;Lederer, Ann-Kathrin;Wittel, Uwe A.
背景胰腺转移是胰腺外科手术的罕见原因，通常是晚期疾病的标志，没有治愈性治疗的机会。然而，手术治疗转移瘤可能是提高患者生存率的一种有前途的方法。本研究的目的是分析胰腺转移瘤切除术后的手术和肿瘤学结局。方法这是一项回顾性队列分析，对2005年至2017年在弗赖堡大学胰腺中心接受胰腺切除术的前瞻性管理患者数据库进行回顾性分析。结果1297例患者中29例（2%）因胰腺转移而行胰腺切除术。20例（69%）患者显示肾细胞癌（mRCC）转移，其次是黑色素瘤（n = 5，17%）、结肠癌（n = 2，7%）、卵巢癌（n = 1，3%）和小肠神经内分泌肿瘤（n = 1，3%）转移。2例（7%）患者围手术期死亡。中位随访时间为76.4（范围21-132）个月。5-年和总生存率分别为82%（mRCC 89% vs.非mRCC 67%）和70%（mRCC 78% vs.非mRCC 57%）。与其他原发性肿瘤实体患者相比，mRCC患者的无病生存期较短（14 vs 22个月）。结论尽管存在恶性疾病，胰腺转移瘤切除术后患者的总生存期是可以接受的。较好的生存率似乎与原发肿瘤实体相关。进一步的研究应集中在分子标志物，以阐明胰腺转移的机制，选择合适的治疗方法，为个体化患者。
Background Pancreatic metastasis is a rare cause for pancreas surgery and often a sign of advanced disease no chance of curative-intent treatment. However, surgery for metastasis might be a promising approach to improve patients' survival. The aim of this study was to analyze the surgical and oncological outcome after pancreatic resection of pancreatic metastasis. Methods This is a retrospective cohort analysis of a prospectively-managed database of patients undergoing pancreatic resection at the University of Freiburg Pancreatic Center from 2005 to 2017. Results In total, 29 of 1297 (2%) patients underwent pancreatic resection due to pancreatic metastasis. 20 (69%) patients showed metastasis of renal cell carcinoma (mRCC), followed by metastasis of melanoma (n = 5, 17%), colon cancer (n = 2, 7%), ovarian cancer (n = 1, 3%) and neuroendocrine tumor of small intestine (n = 1, 3%). Two (7%) patients died perioperatively. Median follow-up was 76.4 (range 21-132) months. 5-year and overall survival rates were 82% (mRCC 89% vs. non-mRCC 67%) and 70% (mRCC 78% vs. non-mRCC 57%), respectively. Patients with mRCC had shorter disease-free survival (14 vs. 22 months) than patients with other primary tumor entities. Conclusion Despite malignant disease, overall survival of patients after metastasectomy for pancreatic metastasis is acceptable. Better survival appears to be associated with the primary tumor entity. Further research should focus on molecular markers to elucidate the mechanisms of pancreatic metastasis to choose the suitable therapeutic approach for the individual patient.