Long-Term Survival After Multidisciplinary Management of Resected Pancreatic Adenocarcinoma

Katz, Matthew H.; Wang, Huamin; Fleming, Jason B.; Sun, Charlotte C.; Hwang, Rosa F.; Wolff, Robert A.; Varadhachary, Gauri R.; Abbruzzese, James L.; Crane, Christopher H.; Krishnan, Sunil; Vauthey, Jean Nicolas; Abdalla, Eddie K.; Lee, Jeffrey E.; Pisters, Peter W.T.; Evans, Douglas B.

doi:10.1245/s10434-008-0295-2

Cited by 446 publications

(320 citation statements)

References 39 publications

(54 reference statements)

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“…Actually, some authors have reported favorable survival results at 5 years following surgical resection for pancreatic cancer patients (23,24). Although the issue of PBD is clinically relevant, PBD should be carried out for patients who undergo neoadjuvant chemo(radio)-therapy.…”

Section: Discussion Discussionmentioning

confidence: 99%

Optimal Duration of Prophylactic Antibiotics Administration in Pancreaticoduodenectomy

Yamamoto¹,

Satoi²,

Yanagimoto³

et al. 2017

SGO

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Purpose: Pancreaticoduodenectomy (PD) is considered a complex surgical procedure that is associated with a high morbidity. There has been no report on the optimal duration of prophylactic antibiotics administration to date. Mortality and morbidity, including surgical site infection (SSI) after PD, were compared retrospectively taking into account the period of prophylactic antibiotics administration. Methods: This study involved 158 patients who underwent PD between April 2006 and December 2010. Until March 2008 our hospital administered prophylactic antibiotics until post-operative day-2, but beginning in April 2008 they were administered only until postoperative day-1. Group A consisted of 71 consecutively treated patients who received cefmetazole (CMZ) as a prophylactic antibiotic intra-operatively and for 2 days postoperatively. Group B consisted of 87 consecutively treated patients who received CMZ intraoperatively and for 1 day post-operatively. During the study period, peri-operative management was standardized according to our departmental guidelines. Results: There were no significant differences in post-operative complications between the two groups. The most commonly isolated microorganisms from surgical drainage fluid were Enterobacter and Enterococcus species. Pre-operative biliary drainage was an independent risk factor for SSI (p<0.05). Conclusion: Limiting prophylactic antibiotics administration until post-operative day-1 did not increase morbidity after PD. However, we recommend long-term administration of prophylactic antibiotics for patients who undergo pre-operative biliary drainage.

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Section: Discussion Discussionmentioning

confidence: 99%

Optimal Duration of Prophylactic Antibiotics Administration in Pancreaticoduodenectomy

Yamamoto¹,

Satoi²,

Yanagimoto³

et al. 2017

SGO

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“…Such a situation is seldom experienced in the case of liver metastasis, but it is true beyond doubt that such a unique group of patients exists in the case of lung metastasis. Katz et al 4 analyzed 329 resected cases of pancreatic cancer and evaluated the pattern of recurrence associated with long-time survival. Recurrence rate was 70% and long-term survival for more than 5 years was 26.7%.…”

Section: Discussionmentioning

confidence: 99%

Appraisal of Aggressive Excisional Biopsy for a Possible Isolated Lung Metastasis of Pancreatic Cancer: Repeated Extirpation Contributes to Long Survival

Takahashi

Yoshioka

Uchinami

et al. 2016

International Surgery

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Although rare, there is a group of patients in whom lung metastases of pancreatic cancer develop isolatedly. We here report two cases of isolated lung metastasis of pancreatic cancer who gained long survival by repeated surgical resections of the nodules. Case 1: A 63-year-old man developed a 5-mm isolated lung metastasis 25 months after distal pancreatectomy for the primary cancer. He underwent an excisional biopsy for diagnosis and treatment. Although new lesions developed after this excision, additional extirpation of the chemotherapy-resistant tumor nodule realized a tumor-free survival for 15 months and total 74 months survival since pancreatectomy. Case 2: A 75-year-old man developed a 10-mm isolated lung metastasis of pancreatic cancer 13 months after distal pancreatectomy and underwent an excisional biopsy. In spite of adjuvant chemotherapy, 18 months later, a new lesion developed in the lung field neighboring the site of the first metastasis. He received a redo resection and has had a tumor-free period for 20 months until now. He has survived for 55 months since distal pancreatectomy. Aggressive excisional biopsy and repeated surgical resection could be recommended as a treatment option for isolated lung metastasis of pancreatic cancer.

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“…Katz et al (11) reported that the median overall survival was significantly longer for patients with isolated pulmonary recurrence (40.3 months) than with other metastases (20.9 months; hazard ratio 5.85, p=0.0156). Thomas et al (7) reported their experience with 21 selective resections of solitary metastases, including seven lung metastases.…”

Section: Anticancer Researchmentioning

confidence: 99%

Surgical Treatment for Pulmonary Metastasis of Pancreatic Ductal Adenocarcinoma: Study of 12 Cases

2017

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Abstract. Background Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy. The American Cancer Society estimated approximately 48,960 patients diagnosed with PDAC in 2015, with more than 40,560 deaths attributable to the disease (1). The median 5-year survival of 6% is likely a result of the tumor's invasiveness and propensity toward metastasis (2). Once PDAC has metastasized to distant organs, the prognosis is dismal with an overall 5-year survival of only 1% (3, 4).Pulmonary metastasectomy has been shown to provide a survival benefit for colorectal cancer patients with pulmonary metastases (5). And recently, Karagkiouzis et al. (6) reported that combined surgical resection of primary non-small cell lung cancer and solitary hematogenous metastasis might be associated with improved survival. Recurrent PDAC, in comparison, has been notoriously difficult to manage surgically as it is typically characterized by aggressive growth, a multifocal pattern of recurrence, and technically unresectable disease (7). Therefore, although the lung is one of the common sites for distant metastasis in PDAC patients (8) Patients and MethodsThis study evaluated 12 patients who underwent surgical treatment for pulmonary metastasis of pancreatic cancer and were then histologically diagnosed with PDAC between January 2004 and December 2016 at our institute. The pulmonary metastases were isolated without evidence of other sites of disease recurrence at the time of metastasectomy. The exclusion criteria for entry to the study were complications from other malignant diseases after enrollment. Thus, the lungs represented the first recurrence site of metastasis in this study. Data were collected from patient's medical charts, operative notes and pathologic examination records. Follow-up data were gathered from outpatient clinic records.Because individual patients were not identified in this retrospective study, the Ethics Review Board of our institute waived the requirement to obtain written informed consent from patients and approved the study protocol.We used the VATS technique to resect pulmonary metastases. Fortunately, there was no need for conversion to open thoracotomy for any patient in this series. 5573

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Long-Term Survival After Multidisciplinary Management of Resected Pancreatic Adenocarcinoma

Cited by 446 publications

References 39 publications

Optimal Duration of Prophylactic Antibiotics Administration in Pancreaticoduodenectomy

Optimal Duration of Prophylactic Antibiotics Administration in Pancreaticoduodenectomy

Appraisal of Aggressive Excisional Biopsy for a Possible Isolated Lung Metastasis of Pancreatic Cancer: Repeated Extirpation Contributes to Long Survival

Surgical Treatment for Pulmonary Metastasis of Pancreatic Ductal Adenocarcinoma: Study of 12 Cases

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