About this Journal Submit a Manuscript Table of Contents
HPB Surgery
Volume 2010 (2010), Article ID 579672, 6 pages
http://dx.doi.org/10.1155/2010/579672
Clinical Study

Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

1Department of Gynecology, North-West-Hospital Frankfurt, Academic Teaching Hospital, University of Frankfurt, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany
2Department of General Surgery, St. Joseph Hospital, Ruhr-University, Gudrunstraβe 56, 44791 Bochum, Germany
3Institute for Pathology, BG Kliniken Bergmannsheil, Ruhr-University, Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
4Department of Surgery, Clinics of the Main Taunus County, Academic Teaching Hospital, University of Frankfurt, Kronberger Straβe 36, 65812 Bad Soden, Germany

Received 11 July 2010; Accepted 31 October 2010

Academic Editor: B. Rau

Copyright © 2010 S. K. Seelig et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. For M1 pancreatic adenocarcinomas pancreatic resection is usually not indicated. However, in highly selected patients synchronous metastasectomy may be appropriate together with pancreatic resection when operative morbidity is low. Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years) identified. The primary tumor was located in the pancreatic head ( 𝑛 = 9 , 45%), in pancreatic tail ( 𝑛 = 9 , 45%), and in the papilla Vateri ( 𝑛 = 2 , 10%). Metastases were located in the liver ( 𝑛 = 1 4 , 70%), peritoneum ( 𝑛 = 5 , 25%), and omentum majus ( 𝑛 = 2 , 10%). Lymphnode metastases were present in 16 patients (80%). All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months) which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; 𝑃 = . 1 ). Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis.