Sweeney Alex D, Wu Meng-Fen, Hilsenbeck Susan G, Brunicardi F Charles, Fisher William E
The Elkins Pancreas Center, Dan L. Duncan Cancer Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
J Surg Res. 2009 Oct;156(2):189-98. doi: 10.1016/j.jss.2009.01.017. Epub 2009 Feb 10.
Cancer metastatic to the pancreas from other primary sites is uncommon, and it has been treated with an aggressive surgical approach in fit patients when the primary tumor is controlled and the pancreas is the only site of metastatic disease. The value of pancreatic resection in this setting is unclear. The purpose of this study was to review cases of cancer metastatic to the pancreas.
We reviewed our experience with cancer metastatic to the pancreas and the literature regarding resection of pancreatic metastases. Patient and tumor characteristics were summarized using descriptive statistics.
A total of 220 patients with pancreatic metastasis were analyzed. Three patients were selected from our own experience, and 217 were selected from a literature review. In the 127 patients whose symptoms were recorded at the time of presentation, the most common presenting symptoms were jaundice (n=32, 25.2%) and abdominal pain (n=25, 19.7%). In the 189 patients for whom the location of the metastasis in the pancreas was revealed, the most common location was the head of the pancreas (n=79, 41.8%). The primary tumor site was most commonly kidney (n=155, 70.5%). Surgical resection was attempted in 177 of 220 patients; 135 patients suffering from renal cell carcinoma (RCC) metastasis also underwent pancreatic resection. In the latter group, a median survival of 70 mo was seen, as well as 78% and 65% 2- and 5 y survival rates, respectively.
Survival after resection of RCC with isolated metastasis to the pancreas is favorable. However, a more detailed analysis considering outcomes without surgery for each primary tumor site is needed before the value of this aggressive surgical approach can be completely assessed in the general occurrence of pancreatic metastasis.
癌症从其他原发部位转移至胰腺并不常见，对于身体状况适宜的患者，当原发肿瘤得到控制且胰腺是唯一转移病灶部位时，会采用积极的手术方法进行治疗。在这种情况下，胰腺切除术的价值尚不清楚。本研究的目的是回顾癌症转移至胰腺的病例。
我们回顾了癌症转移至胰腺的病例经验以及有关胰腺转移瘤切除术的文献。使用描述性统计方法总结患者和肿瘤特征。
共分析了220例胰腺转移患者。其中3例来自我们自己的经验，217例来自文献回顾。在127例就诊时记录了症状的患者中，最常见的症状是黄疸（n = 32，25.2%）和腹痛（n = 25，19.7%）。在189例明确了胰腺转移部位的患者中，最常见的转移部位是胰头（n = 79，41.8%）。原发肿瘤部位最常见的是肾脏（n = 155，70.5%）。220例患者中有177例尝试进行手术切除；135例肾细胞癌转移患者也接受了胰腺切除术。在后一组中，中位生存期为70个月，2年和5年生存率分别为78%和65%。
孤立转移至胰腺的肾细胞癌切除术后生存率良好。然而，在全面评估这种积极手术方法在胰腺转移总体情况中的价值之前，需要对每个原发肿瘤部位不进行手术的结果进行更详细的分析。
