Clinic of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89071, Germany.
Int J Mol Sci. 2013 Feb 19;14(2):4163-73. doi: 10.3390/ijms14024163.
Pancreatic cancer is a fatal disease with a 5-year survival rate below 5%. Most patients are diagnosed at an advanced tumor stage and existence of distant metastases. However, involvement of the central nervous system is rare in pancreatic cancer. We retrospectively analyzed all cases of brain metastases in pancreatic cancer reported to date focusing on patient characteristics, clinical appearance, therapy and survival. Including our own, 12 cases of brain metastases originating from pancreatic cancer were identified. In three patients brain metastases were the first manifestation of pancreatic cancer. All other patients developed brain metastases during their clinical course. In most cases, the disease progressed rapidly and the patients died within weeks or months. However, two patients showed long-term survival. Of note, both patients received resection of the pancreatic cancer as well as curative resection of the metachronous brain metastases. Brain metastases in pancreatic cancer are a rare condition and usually predict a very poor prognosis. However, there is evidence that resection of brain metastases of pancreatic cancer can be immensely beneficial to patient's survival, even with the chance for cure. Therefore, a surgical approach in metastatic pancreatic cancer should be considered in selective cases.
胰腺癌是一种致命疾病，5 年生存率低于 5%。大多数患者在肿瘤晚期和存在远处转移时被诊断出来。然而，胰腺癌中涉及中枢神经系统的情况很少见。我们回顾性分析了迄今为止报道的所有源自胰腺癌的脑转移病例，重点关注患者特征、临床表现、治疗和生存情况。包括我们自己的病例在内，共发现 12 例源自胰腺癌的脑转移病例。在 3 例患者中，脑转移是胰腺癌的首发表现。其他所有患者在其病程中均发生脑转移。在大多数情况下，疾病进展迅速，患者在数周或数月内死亡。然而，有 2 例患者表现出长期生存。值得注意的是，这 2 例患者均接受了胰腺癌切除术和同步脑转移的根治性切除术。胰腺癌的脑转移是一种罕见情况，通常预示着预后极差。然而，有证据表明，切除胰腺癌的脑转移可以极大地有益于患者的生存，甚至有治愈的机会。因此，在选择性病例中，转移性胰腺癌的手术方法应被考虑。
