Department of Hepatobiliary and Pancreatic Surgery, The Royal London Hospital, Barts and The London NHS Trust, Whitechapel, London, UK.
HPB (Oxford). 2008;10(6):498-500. doi: 10.1080/13651820802356598.
The majority of pancreatic tumors are primary. The pancreas can however be the site of metastasis from renal cell cancer, lung, colon and breast cancers. The value of surgical treatment is unclear in such situations. The aim of this study was to evaluate the outcome of surgical therapy in patients with isolated metastases to the pancreas.
All patients who underwent pancreatic surgery for malignant disease from 1999 to 2005 (n=338) at the department of hepatobiliary and pancreatic surgery, the Royal London Hospital, London, were evaluated from a retrospective pancreatic database. Five patients had metastatic pancreatic cancer. Surgical outcome and survival were examined in this subset of patients.
The primary cancer was renal cell carcinoma (n=2), breast (n=1), colon (n=1) and ovarian (n=1). The two patients with renal cell carcinoma developed pancreatic metastases years from the primary diagnosis. Both patients are alive 56 and 36 months post surgery. Two patients with breast and ovarian primary presented years after diagnosis of the primary but had advanced unresectable disease. There was one patient with colonic primary and synchronous pancreatic metastasis, and had a colectomy and Whipple's operation, and is alive 64 months postoperatively.
The pancreas is an uncommon site for metastasis. Patients can present years after the treatment of primary. Long-term survival can be achieved with pancreatic resection in a highly selected subset of patients, and patients with primary renal cell carcinoma seem to have a favorable prognosis.
大多数胰腺肿瘤为原发性肿瘤。然而，胰腺也可能是肾癌、肺癌、结肠癌和乳腺癌转移的部位。在这种情况下，手术治疗的价值尚不清楚。本研究旨在评估胰腺孤立转移患者手术治疗的效果。
从 1999 年至 2005 年在伦敦皇家医院肝胆胰腺外科进行胰腺恶性疾病手术的所有患者（n=338）都从回顾性胰腺数据库中进行了评估。其中 5 例患者患有转移性胰腺癌。在这部分患者中检查了手术结果和生存情况。
原发性癌症为肾癌（n=2）、乳腺癌（n=1）、结肠癌（n=1）和卵巢癌（n=1）。两名患有肾癌的患者在原发性诊断多年后出现了胰腺转移。两名患者在手术后分别存活了 56 个月和 36 个月。两名患有乳腺癌和卵巢癌的患者在原发性诊断多年后出现了进展性不可切除的疾病。有一名患有结肠癌的患者，同时患有胰腺转移，接受了结肠切除术和胰十二指肠切除术，术后 64 个月仍存活。
胰腺是转移的罕见部位。患者可能在原发性疾病治疗多年后出现。在高度选择的患者亚组中，胰腺切除术可以实现长期生存，并且原发性肾癌患者似乎预后良好。
