Pancreatectomy for metastatic disease: A systematic review

Adler, Hugh; Redmond, Ciaran E.; Heneghan, Helen; Swan, Niall; Maguire, Donal; Traynor, O.; Hoti, Emir; Geoghegan, Justin; Conlon, Kevin C.

doi:10.1016/j.ejso.2013.12.022

Cited by 74 publications

(78 citation statements)

References 44 publications

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“…The most common indication for pancreatic metastasectomy is spread from renal cell carcinoma (RCC), whereas the most common metastatic sites of lung cancer are the adrenal glands, liver, brain, and bones (2,3). A previous systematic review identified only 27 publications with data from 32 patients who underwent pancreatic metastasectomy for metastases from lung cancer (4).…”

Section: Introductionmentioning

confidence: 99%

Pancreatic metastasis from non-small-cell lung cancer diagnosed using endoscopic ultrasound-guided fine needle aspiration biopsy: A case report

Kurihara

Saito²,

Nanjo³

et al. 2017

Turk J Gastroenterol

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INTRODUCTIONPancreatic metastasis from the lungs is rare and accounts for less than 5% of pancreatic malignancies that are not detected on autopsy (1). The most common indication for pancreatic metastasectomy is spread from renal cell carcinoma (RCC), whereas the most common metastatic sites of lung cancer are the adrenal glands, liver, brain, and bones (2,3). A previous systematic review identified only 27 publications with data from 32 patients who underwent pancreatic metastasectomy for metastases from lung cancer (4). Therefore, detection of metastatic lung cancer to the pancreas is relatively rare in a living patient (i.e., not on autopsy). Furthermore, detection of small pancreatic tumors and differentiating between malignant and benign etiologies are difficult. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) is a useful modality to improve the diagnosis of pancreatic tumors and to guide the treatment plan (5). In this study, we described a rare case of pancreatic metastasis from non-small-cell lung cancer (NSCLC) that was diagnosed using EUS-FNAB. CASE PRESENTATIONA 56-year-old man with a smoking history of 42 packyears underwent regular follow-up computed tomography (CT) scans for adult-onset type II citrullinemia and idiopathic pulmonary fibrosis. In 2015, CT scan revealed a right upper lobe nodule measuring 31 mm in diameter; no mass was observed in the pancreas (Figure 1). Bronchoscopy was performed, and he was diagnosed with adenocarcinoma using brush cytology. Positron emission tomography/CT (PET/CT) showed high fluorodeoxyglucose uptake in the right upper lobe nodule and no abnormal uptake in the hilar and mediastinal lymph nodes, as well as in other organs, including the pancreas (Figure 2).Based on a clinical staging of cT2aN0M0 (stage IB), we decided to surgically resect the lung cancer. Two months after the nodule was detected, we performed a repeat CT scan (Synapse Vincent; Fujifilm Medical, Tokyo, Japan) to prepare a preoperative three-dimensional imaging of the pulmonary vessels and bronchi. 2017; 28: 502-4 Pancreatic metastasis from non-small-cell lung cancer diagnosed using endoscopic ultrasound-guided fine needle aspiration biopsy: A case report 502 ABSTRACT A 56-year-old man presented with a chest computed tomography (CT) finding of a right upper lobe nodule, which was diagnosed using brush cytology as adenocarcinoma stage IB (cT2aN0M0). Repeat CT scan for preoperative evaluation revealed a small, slightly hypodense spot in the pancreatic body, which was diagnosed as pancreatic metastasis from lung cancer using endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). Because of the presence of distant metastasis, surgical resection was deferred and chemotherapy was chosen instead. Pancreatic metastasis from non-small-cell lung cancer (NSCLC) is rare and might present with few symptoms when the tumor is small. EUS-FNAB is a useful modality for detecting and providing accurate histological diagnosis of pancreatic tumors. Although pancreatic metastasis...

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Section: Introductionmentioning

confidence: 99%

Pancreatic metastasis from non-small-cell lung cancer diagnosed using endoscopic ultrasound-guided fine needle aspiration biopsy: A case report

Kurihara

Saito²,

Nanjo³

et al. 2017

Turk J Gastroenterol

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“…However, in a report of 190 autopsy cases by Adsay et al (1), 42% patients (81/190) exhibited metastases in the pancreas. This number is significantly higher than the generally accepted incidence rate (6). Therefore, the proportion of patients affected by pancreatic metastases is speculated to be significantly higher based on the longer lifespans and improved sensitivity of diagnostic medical examinations.…”

Section: Discussionmentioning

confidence: 59%

“…In the present study, 3 of the 4 patients were male. However, in previously published reports, the distribution was equal between the two sexes (6,15). Pancreatic metastases can occur in any part of the pancreas.…”

Section: Discussionmentioning

confidence: 76%

“…Previous studies have indicated that the kidney may be more common than the lung as a primary tumor site of metastases to the pancreas (1,4). Symptoms of pancreatic metastases are often not apparent, and these lesions are thus detected incidentally by physical examination in the majority of cases (6). Abdominal computed tomography (CT) scan and magnetic resonance imaging (MRI) examinations can be used in the differential diagnosis of pancreatic lesions (7).…”

Section: Introductionmentioning

confidence: 99%

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Clinical diagnosis and detection of genetic mutations of pancreatic metastases: A report of four cases and review of the literature

Zhang

et al. 2017

Oncology Letters

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Abstract. The present study aimed to report our clinical experience regarding the diagnosis and detection of genetic mutations of pancreatic metastases, and to review the relevant literature to expand knowledge of this disease. A total of 4 cases involving pancreatic metastases, which were treated at The First Affiliated Hospital of Soochow University between January 2013 and July 2016, were retrospectively analyzed. This retrospective study considered the clinicopathological variables of the 4 patients, and compared this data with those from the literature, which was searched using PubMed, EMBASE and the Cochrane Library. All 4 patients with pancreatic metastases were diagnosed by computed tomography (CT) scan and confirmed by pathological staining and immunohistochemistry. Mutation analysis was performed in 3 patients to obtain precise mutation information for guiding and evaluating the use of molecularly targeted drugs. In summary, pancreatic metastases are rare and the majority of pancreatic metastases develop from renal cell carcinoma. Diagnoses of pancreatic metastases predominantly rely on CT, pathology and immunohistochemistry. Detection of mutations has clinical value in auxiliary diagnosis and therapy of pancreatic metastases. Based on mutation information, molecularly targeted drugs may prolong the survival of patients with unresectable pancreatic metastases. IntroductionPancreatic metastases are rare. Metastases are reported to account for 2-5% of all malignant lesions occurring in the pancreas (1-5). Studies have reported that people of ~60 years old are at high risk of developing pancreatic metastases (1-3). Metastases to the pancreas may occur a significant amount of time subsequent to diagnosis and management of the primary tumor (3). Primary tumors that may give rise to pancreatic metastases include renal cell carcinoma (RCC), non-small cell lung carcinoma, melanoma, sarcoma and colorectal carcinoma. Previous studies have indicated that the kidney may be more common than the lung as a primary tumor site of metastases to the pancreas (1,4). Symptoms of pancreatic metastases are often not apparent, and these lesions are thus detected incidentally by physical examination in the majority of cases (6). Abdominal computed tomography (CT) scan and magnetic resonance imaging (MRI) examinations can be used in the differential diagnosis of pancreatic lesions (7). Pathological analysis is the gold standard in the diagnosis of pancreatic metastases (8). However, occasionally it is difficult to diagnose pancreatic metastasis based on pathology alone (9).In recent years, pancreatic metastases have been observed with increasing frequency, particularly at high-volume pancreatic surgery centers, due to increased utilization of advanced imaging methods, including ultrasonography, CT, MRI and endoscopic ultrasonography (EUS) (10). However, the treatment for pancreatic metastases remains controversial. The majority of patients with pancreatic metastases are in the advanced stages of primary disease (11); however, t...

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“…Metastatic lesions (of any tumor type) to the pancreas are quite rare, composing approximately 2% of all pancreatic malignancies; a systemic review has shown that pancreatic metastasectomy provides a survival benefit in select cases [10]. One retrospective review of tumors with metastasis to the pancreas identified one case of an ileal NET amongst other primary tumors [11].…”

Section: Discussionmentioning

confidence: 99%