Moletta Lucia, Friziero Alberto, Serafini Simone, Grillo Valeria, Pierobon Elisa Sefora, Capovilla Giovanni, Valmasoni Michele, Sperti Cosimo
Department of Surgery, Oncology and Gastroenterology, 1st Surgical Clinic, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
J Clin Med. 2023 Feb 1;12(3):1171. doi: 10.3390/jcm12031171.
Pancreatic metastases from other neoplasms are rare. The role of surgery for this clinical entity is unclear. The aim of this study was to investigate the role of resection in patients with pancreatic secondary lesions. We observed 44 patients with pancreatic metastases from other tumors. Renal cell carcinoma was the most common primary tumor ( = 19, 43.2%). Thirty-seven patients underwent surgery, and pancreatic resection with curative intent was feasible in 35 cases. Fifteen patients (43.2%) experienced major postoperative complications (Clavien-Dindo > 2), and postoperative mortality rate was 5.4%. The median overall survival and disease-free survival were 38 (range 0-186) and 11 (range 0-186) months, respectively. Overall survival and disease-free survival were significantly longer for pancreatic metastases from renal cell carcinoma when compared to other primary tumors. Multivariate analysis confirmed a pathological diagnosis of metastasis from RCC as an independent prognostic factor for overall survival (OR 2.48; 95% CI, 1.00-6.14; = 0.05). In conclusion, radical resection of metastases to the pancreas is feasible and safe, and may confer a survival benefit for selected patients. There is a clear benefit of metastasectomy in terms of patient survival for metastases from renal cell carcinoma, while for those with other primary tumors, surgery seems to be mainly palliative.
其他肿瘤的胰腺转移很少见。手术在这种临床情况中的作用尚不清楚。本研究的目的是探讨切除在胰腺继发性病变患者中的作用。我们观察了44例来自其他肿瘤的胰腺转移患者。肾细胞癌是最常见的原发肿瘤（n = 19，43.2%）。37例患者接受了手术，35例可行根治性胰腺切除术。15例患者（43.2%）发生了严重术后并发症（Clavien-Dindo＞2级），术后死亡率为5.4%。中位总生存期和无病生存期分别为38个月（范围0 - 186个月）和11个月（范围0 - 186个月）。与其他原发肿瘤相比，肾细胞癌胰腺转移患者的总生存期和无病生存期显著更长。多因素分析证实肾细胞癌转移的病理诊断是总生存期的独立预后因素（OR 2.48；95%CI，1.00 - 6.14；P = 0.05）。总之，胰腺转移瘤的根治性切除是可行且安全的，可能为部分患者带来生存获益。对于肾细胞癌转移患者，转移瘤切除术在患者生存方面有明显益处；而对于其他原发肿瘤患者，手术似乎主要是姑息性的。
