SSAT - Efficacy of Pulmonary Metastasectomy for Pancreatic Cancer Metastases

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Efficacy of Pulmonary Metastasectomy for Pancreatic Cancer Metastases
Yoichi Miyata^*, Minoru Esaki, Yoji Kishi, Satoshi Nara, Kazuaki Shimada
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center, Tokyo, Japan

Background and aim: There is no consensus whether surgical resection of pulmonary metastases of pancreatic invasive ductal cancer in selected patients contribute to long-term survival.
Methods: Among 732 patients who underwent pancreatectomies for invasive pancreatic ductal carcinoma between 2000 and 2014, 77 patients with pulmonary metastases as the initial recurrence were included. Recurrence types and outcome of therapy were investigated.
Results: The number of patients with solitary pulmonary metastasis (group A), multiple pulmonary metastases with (group B) and without other organ metastasis (group C) as initial recurrence were 16, 31 and 30, respectively. Overall survival (OS) was 26, 14 and 10 months, respectively. It was significantly different among the three groups (group A vs. group B, p=0.017; group B vs. group C, p=0.027). Metastasectomies were performed in 11 patients, 10 in group A (group A1) and 1 in group B. The other 6 patients in group A did not undergo metastasectomy (group A2), 3 of whom underwent chemotherapy and the other 3 received only best supportive care. Disease free interval (DFI; period between pancreatectomy and definition of pulmonary metastases) of group A1 and A2 was 44 (21-82) and 17 (7-39) months, respectively. Although OS of group A1 tended to be longer than that of group A2, there was no significantly different (p=0.077). Median survival time of group A1 and A2 after treatment of recurrence was 36 (2-60) and 16 (14-31) months, respectively. Six patients in group A1 and 3 in group A2 survived longer than 24 months.
Conclusion: Although the present results only showed the outcomes of selected patients, surgical resection of late onset solitary pulmonary metastasis can be a feasible treatment for pancreatic cancer.

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