Outcomes of lung metastasis from pancreatic cancer: A nationwide multicenter analysis

Homma, Yoshimi; Endo, Itaru; Matsuyama, Ryusei; Sho, Masayuki; Mizuno, Shugo; Seyama, Yousuke; Hirano, Satoshi; Aono, Takashi; Kitami, Chie; Morita, Yoshifumi; Takeda, Yutaka; Yoshida, Kazuhiro; Tani, Masaji; Koyama, Takashi; Yamamoto, Yūzō; Aoki, Hideki; Ogawa, Michio; Niguma, Takefumi; Mataki, Yuko; Kawasaki, Hiroshi; Baba, Hideo; Yasuda, Hiroshi; Rikiyama, Toshiki; Yamaue, Hiroki; Yamamoto, Masakazu

doi:10.1002/jhbp.1127

Cited by 24 publications

(31 citation statements)

References 23 publications

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“…Unlike liver and peritoneal metastases, lung oligometastasis appears to have a better prognosis in pancreatic cancer (Table 3) [25][26][27][28][29][30][31][32][33]. Therefore, surgery for lung oligometastasis may play a more important role than surgery for other types of oligometastases.…”

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

“…The median OS after initial anti-cancer therapy, including surgery or chemotherapy, and lung resection was ranged from 51 to 121 months and 27 to 47 months, respectively [25][26][27][28][29][30]32]. Thomas et al [26] reported that the median OS after initial treatment was significantly longer in patients with lung oligometastasis recurrence than in those with liver oligometastasis recurrence among patients undergoing surgery.…”

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

“…Thomas et al [26] reported that the median OS after initial treatment was significantly longer in patients with lung oligometastasis recurrence than in those with liver oligometastasis recurrence among patients undergoing surgery. Recently, Homma et al [32] conducted a nationwide survey in multiple centers in Japan. This is the most extensive study to date.…”

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

“…Additionally, resection for lung metastasis can be further considered in patients with a relatively long interval between initial pancreatic resection and the diagnosis of lung metastasis [26,29,30]. Serum CA19-9 levels before lung resection and single lung metastasis have been reported to predict favorable prognosis [32].…”

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

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Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

Sho

Yasuda

Nagai

et al. 2023

JDCR

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Pancreatic cancer is one of the most difficult human malignancies to treat. Surgery is generally contraindicated in advanced pancreatic cancer, even with one distant metastatic lesion [1]. However, recent advancements in the treatment of pancreatic cancer may change therapeutic concepts and strategies, even for metastatic pancreatic cancer. Even in cases of advanced pancreatic cancer, we occasionally see unexpectedly positive benefits of anticancer therapy in daily clinical practice. In such cases, surgical resection might result in long-term survival or even a complete cure. Oligometastasis is considered an intermediate state between localized and polymetastatic disease [2]. Currently, the best treatment for oligometastasis in pancreatic cancer, despite being widely discussed, remains controversial. There are several clinical questions regarding oligometastasis in pancreatic cancer. First, what is the definition of oligometastasis in pancreatic cancer? Second, does surgery play a significant role in the multidisciplinary treatment, even in patients with oligometastasis? Third, what is an appropriate biomarker to predict efficacy of treatment and determine surgical indications in oligometastatic pancreatic cancer?In this review, we present an update on the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer, and discuss future perspectives.

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Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

Section: Surgery For Oligometastasis Of the Lungmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

Sho

Yasuda

Nagai

et al. 2023

JDCR

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“…Tumor metastasis contributes to cancer associated mortality risk (2). Lung metastasis of PDAC occurs in a significant number of patients and represents the high severity of the disease and is associated with poor clinical outcome (3).…”

Section: Introductionmentioning

confidence: 99%

NLRP3 activation in tumor-associated macrophages enhances lung metastasis of pancreatic ductal adenocarcinoma

Gu¹,

Deng²,

Zhang³

et al. 2022

Transl Lung Cancer Res

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Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer and is highly malignant due to its late diagnosis and early metastasis. Lung metastasis of PDAC occurs in a significant number of diagnosed patients and represents high severity of disease and poor clinical outcome.However, the molecular regulation of lung metastasis of PDAC is still not fully understood. Tumorassociated macrophages (TAMs) have recently been found to play an important role in cancer initiation, proliferation, progression, and metastasis. The proliferation, differentiation, and polarization of macrophages has been shown to be regulated by interleukin 1β (IL-1β), which is generated by NLR family pyrin domain containing 3 (NLRP3)-induced formation of inflammasome. Herein we investigated whether NLRP3 plays a role in lung metastasis of PDAC through regulation of macrophage polarization.Methods: Gene profiles for NLRP3 (+/+) and NLRP3 (−/−) macrophages obtained from the Gene Expression Omnibus (GEO) public database were compared and analyzed for altered genes related to macrophage polarization. The regulation of macrophage polarization by NLRP3 was examined in a coculture system with naïve NLRP3 (+/+) or NLRP3 (−/−) macrophages and PDAC cells. Cell growth was analyzed by a Cell Counting Kit-8 (CCK-8) assay. Cell invasiveness and migratory potential were analyzed by transwell cell invasion assay and cell migration assay, respectively. PDAC formation and lung metastasis were analyzed in a mouse model of PDAC with and without NLRP3 knockout.Results: GEO database analysis revealed significant alteration in genes that regulate macrophage polarization in NLRP3-depleted macrophages. NLRP3-depletion in macrophages seemed to favor an M1/ M2b polarization. In vitro, the presence of NLRP3 in macrophages led to M2a/c/d TAM-like polarization when they were cocultured with PDAC cells. Conversely, NLRP3 depletion in macrophages led to M1/M2b polarization when they were cocultured with PDAC cells. NLRP3-depletion significantly inhibited tumor growth and stage progression in a mouse model of PDAC and significantly reduced the occurrence of lung metastasis.Conclusions: Our results suggested that NLRP3 activation in TAM enhanced lung metastasis of PDAC through regulation of TAM polarization.

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Essential updates 2021/2022: Surgical outcomes of oligometastasis in pancreatic ductal adenocarcinoma

Yasuda

Nagai

Terai

et al. 2023

Annals of Gastroent Surgery

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Oligometastatic disease has been proposed as an intermediate state between localized and polymetastatic disease that can benefit from multimodal treatment, including surgery. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma, although there is still little evidence. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarized the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives. In liver oligometastasis, multimodal treatment including surgery achieved favorable long‐term survival, especially in patients with good responses to preoperative chemotherapy, with a median survival time from 25.5 to 54.6 months. In addition, the data from the National Cancer Database in the United States showed that patients who underwent surgery for oligometastatic liver metastases had a significantly longer overall survival than those who received chemotherapy alone. Prognostic biomarkers were identified, including carbohydrate antigen 19–9 (CA19‐9) levels at diagnosis and preoperative chemotherapy with normalization of CA19‐9 levels or favorable radiological response. Patients with lung oligometastasis had a more favorable long‐term prognosis than those with other recurrence sites, and the updated literature further confirmed the previous studies. Overall survival was favorable, with 84 months after initial surgery and 29.2 months after metastasectomy, and a 5‐year survival rate of 60.6% was also reported. In peritoneal oligometastasis, the results of conversion surgery after good responses to preoperative treatment with intraperitoneal therapy or systematic chemotherapy were reported, and the conversion rate and long‐term prognosis were favorable. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes. Furthermore, we summarize the current status of surgery in multidisciplinary treatment of oligometastatic pancreatic cancer and discuss future perspectives.

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Outcomes of lung metastasis from pancreatic cancer: A nationwide multicenter analysis

Cited by 24 publications

References 23 publications

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

NLRP3 activation in tumor-associated macrophages enhances lung metastasis of pancreatic ductal adenocarcinoma

Essential updates 2021/2022: Surgical outcomes of oligometastasis in pancreatic ductal adenocarcinoma

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