Pancreatic Disease Center, Division of Surgical Oncology, Department of Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
J Surg Oncol. 2012 Feb;105(2):156-61. doi: 10.1002/jso.22009. Epub 2011 Jul 2.
Metastasis to the pancreas (PM) is uncommon. Several types of cancers were reported to metastasize to the pancreas. Surgery is advocated in selected patients when technically feasible and if the patient can be rendered disease free.
A retrospective review of PM patients at the University of Cincinnati Pancreas Database was performed over a 7-year time period.
Twenty patients with a median age of 62.5 years were identified. Fifteen patients (75%) were males and (50%) presented with abdominal pain. Nine patients (45.0%) were offered surgical resection, distal pancreatectomy was the most common procedure (n = 4, 44.4%). The commonest pathology was RCC (60%), followed by lung (20%), colon (15%), and breast (5%). Median disease free interval (DFI) was 96 months for RCC, 7 months for other pathologies. Median survival was 19 months for RCC, 8.5 months for other pathologies. Based on DFI, short DFI patients (≤12 months) had worse prognosis (2-year survival of 40%), as opposed to (2-year survival of 80%) in longer DFI patients (P = 0.01). RCC patients with a DFI longer than 94 months had a better survival (P = 0.01). Survival of resected PM tended to be longer than non-resected PM (P = 0.11).
PM from RCC carries a consistently favorable prognosis compared to other pathologies. Surgical resection of PM is a safe and viable option, and, in selected patients, may improve survival. However, a period of expectant management in patients with short DFI may be considered.
胰腺转移（PM）并不常见。有几种类型的癌症被报道转移到胰腺。当技术上可行且患者可以无病时，手术被提倡用于选择的患者。
对辛辛那提大学胰腺数据库中 PM 患者进行了为期 7 年的回顾性研究。
确定了 20 名中位年龄为 62.5 岁的患者。15 名患者（75%）为男性，（50%）出现腹痛。9 名患者（45.0%）接受了手术切除，胰体尾切除术是最常见的手术（n=4，44.4%）。最常见的病理类型是 RCC（60%），其次是肺（20%）、结肠（15%）和乳腺（5%）。RCC 的中位无病间隔（DFI）为 96 个月，其他病变为 7 个月。RCC 的中位生存期为 19 个月，其他病变为 8.5 个月。根据 DFI，短 DFI 患者（≤12 个月）的预后较差（2 年生存率为 40%），而长 DFI 患者（2 年生存率为 80%）（P=0.01）。DFI 超过 94 个月的 RCC 患者的生存率更高（P=0.01）。切除的 PM 生存时间长于未切除的 PM（P=0.11）。
与其他病理类型相比，RCC 引起的 PM 预后一直较好。PM 的手术切除是一种安全可行的选择，在选择的患者中，可能会提高生存率。然而，对于 DFI 较短的患者，可能需要考虑一段时间的期待治疗。
