Metastatic tumors in the pancreas in the modern era

Ioannis T. Konstantinidis, Abdulmetin Dursun, Hui Zheng, Jennifer A. Wargo, Sarah P. Thayer, Carlos Fernandez-Del Castillo, Andrew L. Warshaw, Cristina R. Ferrone

Research output: Contribution to journalArticle

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Abstract

Background Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. Study Design Retrospective review of all pancreatic resections between January 1993 and October 2009. Results We identified 40 patients with a median age of 62 years; 55% were female. Patients most commonly presented with abdominal pain (47.5%). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61%. For RCCs, pancreas was the first site of an extrarenal recurrence in 85% and was synchronous with the primary in 5% of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. Conclusions An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.

Original languageEnglish (US)
Pages (from-to)749-753
Number of pages5
JournalJournal of the American College of Surgeons
Volume211
Issue number6
DOIs
StatePublished - Dec 1 2010

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Pancreas
Metastasectomy
Renal Cell Carcinoma
Neoplasms
Survival
Neoplasm Metastasis
Pancreatectomy
Pancreaticoduodenectomy
Sarcoma
Abdominal Pain
Melanoma
Colon
Retrospective Studies
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Konstantinidis, I. T., Dursun, A., Zheng, H., Wargo, J. A., Thayer, S. P., Fernandez-Del Castillo, C., ... Ferrone, C. R. (2010). Metastatic tumors in the pancreas in the modern era. Journal of the American College of Surgeons, 211(6), 749-753. https://doi.org/10.1016/j.jamcollsurg.2010.08.017

Metastatic tumors in the pancreas in the modern era. / Konstantinidis, Ioannis T.; Dursun, Abdulmetin; Zheng, Hui; Wargo, Jennifer A.; Thayer, Sarah P.; Fernandez-Del Castillo, Carlos; Warshaw, Andrew L.; Ferrone, Cristina R.

In: Journal of the American College of Surgeons, Vol. 211, No. 6, 01.12.2010, p. 749-753.

Research output: Contribution to journalArticle

Konstantinidis, IT, Dursun, A, Zheng, H, Wargo, JA, Thayer, SP, Fernandez-Del Castillo, C, Warshaw, AL & Ferrone, CR 2010, 'Metastatic tumors in the pancreas in the modern era', Journal of the American College of Surgeons, vol. 211, no. 6, pp. 749-753. https://doi.org/10.1016/j.jamcollsurg.2010.08.017
Konstantinidis IT, Dursun A, Zheng H, Wargo JA, Thayer SP, Fernandez-Del Castillo C et al. Metastatic tumors in the pancreas in the modern era. Journal of the American College of Surgeons. 2010 Dec 1;211(6):749-753. https://doi.org/10.1016/j.jamcollsurg.2010.08.017
Konstantinidis, Ioannis T. ; Dursun, Abdulmetin ; Zheng, Hui ; Wargo, Jennifer A. ; Thayer, Sarah P. ; Fernandez-Del Castillo, Carlos ; Warshaw, Andrew L. ; Ferrone, Cristina R. / Metastatic tumors in the pancreas in the modern era. In: Journal of the American College of Surgeons. 2010 ; Vol. 211, No. 6. pp. 749-753.
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title = "Metastatic tumors in the pancreas in the modern era",
abstract = "Background Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. Study Design Retrospective review of all pancreatic resections between January 1993 and October 2009. Results We identified 40 patients with a median age of 62 years; 55{\%} were female. Patients most commonly presented with abdominal pain (47.5{\%}). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61{\%}. For RCCs, pancreas was the first site of an extrarenal recurrence in 85{\%} and was synchronous with the primary in 5{\%} of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. Conclusions An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.",
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AU - Dursun, Abdulmetin

AU - Zheng, Hui

AU - Wargo, Jennifer A.

AU - Thayer, Sarah P.

AU - Fernandez-Del Castillo, Carlos

AU - Warshaw, Andrew L.

AU - Ferrone, Cristina R.

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N2 - Background Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. Study Design Retrospective review of all pancreatic resections between January 1993 and October 2009. Results We identified 40 patients with a median age of 62 years; 55% were female. Patients most commonly presented with abdominal pain (47.5%). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61%. For RCCs, pancreas was the first site of an extrarenal recurrence in 85% and was synchronous with the primary in 5% of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. Conclusions An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.

AB - Background Tumors metastasizing to the pancreas are rare, and published series are limited by few patients treated for extended periods of time. Renal cell cancer (RCC) is the most common primary tumor metastasizing to the pancreas. Our aim was to describe the clinicopathologic characteristics and patient outcomes in a modern series of patients who underwent metastasectomy, with an emphasis on RCC. Study Design Retrospective review of all pancreatic resections between January 1993 and October 2009. Results We identified 40 patients with a median age of 62 years; 55% were female. Patients most commonly presented with abdominal pain (47.5%). Operations performed included 10 pancreaticoduodenectomies, 1 middle, 23 distal, 3 total pancreatectomies, and 3 enucleations. Primary cancers were RCC (n = 20), ovarian (n = 6), sarcoma (n = 3), colon (n = 3), melanoma (n = 2), and others (n = 6). Median survival for all patients after metastasectomy was 4.4 years. Median survival after metastasectomy for RCC was 8.7 years, and the 5-year actuarial survival was 61%. For RCCs, pancreas was the first site of an extrarenal recurrence in 85% and was synchronous with the primary in 5% of patients. There was no survival difference if the time interval to metastasis was shorter than the median (8.7 years), if tumor nodules were multiple or bigger than the median (3 cm), or if the pancreas was not the first site of metastases. Conclusions An aggressive approach to lesions metastatic to the pancreas is often warranted if the patient can be rendered free of disease. Although patients with RCC can experience long-term survival after metastasectomy, survival is less favorable for other primary tumors.

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