Cassalia Fortunato, Bolzon Anna, Ponzano Monica, Ventura Laura, Danese Andrea, Del Fiore Paolo, Belloni Fortina Anna, Jovine Elio, Perri Giampaolo, Cillo Umberto, Marchegiani Giovanni
Dermatology Unit, Department of Medicine [DIMED], University of Padua, 35121 Padua, Italy.
Department of Statistics, University of Padua, 35121 Padova, Italy.
J Clin Med. 2023 Dec 24;13(1):104. doi: 10.3390/jcm13010104.
Pancreatic cancer is notorious for its aggressive nature and low survival rate, with less than 10% of patients surviving beyond five years. Early detection is difficult, but skin metastases can be a rare but significant indicator. This systematic review focuses on the epidemiology, clinical features, and histology of skin metastases from pancreatic cancer to determine their importance in early diagnosis and overall management of the disease.
Following PRISMA guidelines, we conducted an exhaustive search of MEDLINE/PubMed, EMBASE, and SCOPUS databases up to June 2023, using specific keywords. Four independent investigators screened the studies using predefined criteria, and two investigators checked the accuracy and consistency of the data extraction. We assessed the quality of the trials using adapted criteria from the Joanna Briggs Institute. A narrative synthesis rather than a meta-analysis was chosen because of the different study designs.
The final analysis included 57 patients with skin metastases from pancreatic cancer. Cutaneous metastases, although rare, presented with approximately equal gender distribution and a mean age of 63.4 years. Predominantly non-umbilical (77%), these metastases showed clinical diversity, ranging from asymptomatic nodules to painful or ulcerated lesions. Notably, skin metastases often preceded the diagnosis of primary pancreatic cancer (58%). Primary tumor characteristics revealed different localizations, with adenocarcinoma being the most prevalent histological type (77%). A significant association ( = 0.008) was observed between pancreatic tumor location and the timing of presentation of skin metastases. Tumors located in the body and tail of the pancreas were more likely to manifest skin metastases as an initial clinical manifestation (62.2%) than those in the head of the pancreas (20.8%).
In conclusion, although skin metastases are rare, they are important indicators of pancreatic cancer, highlighting the need for multidisciplinary healthcare collaboration and thorough skin examination. Recognizing them could lead to earlier diagnosis, which is crucial in a cancer with limited treatment options.
胰腺癌以其侵袭性和低生存率而臭名昭著，不到10%的患者能存活超过五年。早期检测困难，但皮肤转移瘤可能是一个罕见但重要的指标。本系统评价聚焦于胰腺癌皮肤转移瘤的流行病学、临床特征和组织学，以确定其在疾病早期诊断和整体管理中的重要性。
按照PRISMA指南，我们使用特定关键词对截至2023年6月的MEDLINE/PubMed、EMBASE和SCOPUS数据库进行了详尽检索。四名独立研究者使用预定义标准筛选研究，两名研究者检查数据提取的准确性和一致性。我们使用乔安娜·布里格斯研究所改编的标准评估试验质量。由于研究设计不同，选择了叙述性综合分析而非荟萃分析。
最终分析纳入了57例胰腺癌皮肤转移患者。皮肤转移瘤虽然罕见，但性别分布大致相等，平均年龄为63.4岁。这些转移瘤主要位于非脐部（77%），临床表现多样，从无症状结节到疼痛或溃疡病变不等。值得注意的是，皮肤转移瘤常在原发性胰腺癌诊断之前出现（58%）。原发肿瘤特征显示不同的部位，腺癌是最常见的组织学类型（77%）。观察到胰腺肿瘤位置与皮肤转移瘤出现时间之间存在显著关联（=0.008）。位于胰腺体尾部的肿瘤比胰腺头部的肿瘤更有可能以皮肤转移瘤作为初始临床表现（62.2%比20.8%）。
总之，虽然皮肤转移瘤罕见，但它们是胰腺癌的重要指标，凸显了多学科医疗协作和全面皮肤检查的必要性。认识到它们可能导致更早的诊断，这在治疗选择有限的癌症中至关重要。
