Treatment of Metachronous and Simultaneous Liver Metastases of Pancreatic Cancer

Dünschede, F.; Will, Leon; Langsdorf, C. von; Möhler, Markus; Galle, PR; Otto, G. De; Vahl, Christian F.; Junginger, T

doi:10.1159/000313532

Cited by 65 publications

(95 citation statements)

References 21 publications

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“…There was no difference in survival in patients with synchronous liver metastases of PDAC treated by resection of the primary tumor combined with liver resection versus treatment by gemcitabine (8 vs. 11 months). In patients with metachronous liver metastases, the median survival was increased after metastasectomy compared to patients who were treated with gemcitabine only (31 vs. 11 months, respectively) [39].…”

Section: Role Of Surgerymentioning

confidence: 91%

“…Ideally, this decision is based on a highly individual basis, including the patient's wishes, age, clinical status, local resectability, and the individual risk of complications. However, published data demonstrate that the procedure can be performed safely, but results are inconsistent as to whether complete resection of the PDAC with combined resection of liver metastases will lead to a survival benefit [30,[38][39][40][41][42][43]. Eight reports including more than 9 patients found median overall survival times between 5.9 and 11.4 months after resection [29,39,42,[44][45][46][47][48].…”

Section: Role Of Surgerymentioning

confidence: 99%

“…Most likely owing to a less selective cohort, the group from Mainz argued against simultaneous resection of the primary and liver metastases based on their experience [39]. In contrast, resection of metachronous PDAC liver metastases seems to improve survival in selected patients.…”

Section: Role Of Surgerymentioning

confidence: 99%

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Oligometastatic Disease in Pancreatic Cancer - How to Proceed

Renz

Boeck²,

Roeder

et al. 2017

Visc Med

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Background: Pancreatic cancer is a highly aggressive malignancy and will become the second leading cause of cancer-related death in the USA and also in Germany by 2030. Furthermore, the majority of patients with pancreatic ductal adenocarcinoma (PDAC) will present with distant metastases, limiting surgical management in this population as there is little evidence available to support surgical or ablative treatment options for advanced-stage disease. However, highly selected patients suffering from synchronous and metachronous oligometastatic PDAC may potentially benefit from a surgical resection with an acceptable morbidity. Methods: This review summarizes and discusses the current literature on the management of oligometastatic disease regarding PDAC, focusing on para-aortic lymph nodes as well as isolated hepatic and pulmonary metastases. Results and Conclusion: In order to further investigate the feasibility and efficacy of such an approach, a prospective multicenter trial, in which survival and quality of life after metastatic resection and systemic chemotherapy is evaluated, has to be initiated. Additionally, local and locoregional ablation techniques or stereotactic body radiation therapy as therapeutic options for isolated metastases in PDAC need further research in order to determine their significance and benefit.

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Section: Role Of Surgerymentioning

confidence: 91%

Section: Role Of Surgerymentioning

confidence: 99%

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Oligometastatic Disease in Pancreatic Cancer - How to Proceed

Renz

Boeck²,

Roeder

et al. 2017

Visc Med

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“…Despite the advances in cancer immunology and improvement in surgical as well as non-surgical therapeutic approaches in patients with metastases [14], the overall 5-year survival rate of 5% has not changed significantly [3]. Hence, models that resemble the human situation in pancreatic cancer are required to study the underlying causes of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

A Syngeneic Orthotopic Murine Model of Pancreatic Adenocarcinoma in the C57/BL6 Mouse Using the Panc02 and 6606PDA Cell Lines

Partecke¹,

Sendler

Kaeding³

et al. 2011

Eur Surg Res

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Background/Aims: To develop a clinically relevant immunocompetent murine model to study pancreatic cancer using two different syngeneic pancreatic cancer cell lines and to assess MRI for its applicability in this model. Methods: Two cell lines, 6606PDA and Panc02, were employed for the experiments. Cell proliferation and migration were monitored in vitro. Matrigel™ was tested for its role in tumor induction. Tumor cell growth was assessed after orthotopic injection of tumor cells into the pancreatic head of C57/BL6 mice by MRI and histology. Results: Proliferation and migration of Panc02 were significantly faster than those of 6606PDA. Matrigel did not affect tumor growth/migration but prevented tumor cell spread after injection thus avoiding undesired peritoneal tumor growth. MRI could reliably monitor longitudinal tumor growth in both cell lines: Panc02 had a more irregular finger-like growth, and 6606PDA grew more spherically. Both tumors showed local invasiveness. Histologically, Panc02 showed a sarcoma-like undifferentiated growth pattern, whereas 6606PDA displayed a moderately differentiated glandular tumor growth. Panc02 mice had a significantly shorter (28 days) survival than 6606PDA mice (50 days). Conclusion: This model closely mimics human pancreatic cancer. MRI was invaluable for longitudinal monitoring of tumor growth thus reducing the number of mice required. Employing two different cell lines, this model can be used for various treatment and imaging studies.

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“…From all options currently available for pancreatic cancer patients, surgical resection offers the only potential cure. Patients undergoing pancreatic resection have a 5-year survival rate of 5–15%, with a median survival of 13–17 months [1,2,3,4]. …”

Section: Introductionmentioning

confidence: 99%

Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients

Kaťuchová¹,

Bober²,

Kaťuch³

et al. 2011

Eur Surg Res

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Background /Aims: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. Methods: Between January 2006 and December 2010 at the First Department of Surgery in Košice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical lymphadenectomy were subjected to immunohistochemical staining to detect occult micrometastasis. A comparison of the median survival rate in groups of patients with immunohistochemistry-positive and -negative lymph nodes was performed. Results: Radical pancreatic resection with standard radical lymphadenectomy was performed on 64 pancreatic cancer patients. The median survival time was 15 months. Out of the 319 histopathologically negative lymph nodes (34 patients), 134 lymph nodes were classified as immunohistochemistry positive (21 patients). The median survival rate in the group of patients with immunohistochemistry-negative lymph nodes was 23 months, but in the group of patients with immunohistochemistry-positive lymph nodes it was 14 months. There was a statistically significant difference between these 2 groups of patients (p ≤ 0.01). Conclusion: The immunohistochemical examination of histopathologically negative lymph nodes can lead to positive lymph node detection. The presence of lymph node micrometastasis could predict the survival rate.

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Treatment of Metachronous and Simultaneous Liver Metastases of Pancreatic Cancer

Cited by 65 publications

References 21 publications

Oligometastatic Disease in Pancreatic Cancer - How to Proceed

Oligometastatic Disease in Pancreatic Cancer - How to Proceed

A Syngeneic Orthotopic Murine Model of Pancreatic Adenocarcinoma in the C57/BL6 Mouse Using the Panc02 and 6606PDA Cell Lines

Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients

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