A Clinical Study of Surgical Resection for Metastatic Tumors of Pancreas

Abstract

Introduction: Metastasis to the pancreas is rare condition and it is reported that it accounts for less than 5 percent of all malignancies affecting the pancreas. Method: We performed 7 cases surgical resection for metastatic tumors of pancreas out of 262 cases of pancreas surgery from 2008 to 2018 in our hospital We evaluated the clinical characteristics and patient outcomes. Result: Primary malignancies were renal cell carcinoma (RCC, 6 cases) and thymic carcinoma (1 case). All cases had no extra-pancreatic metastasis. The median age at diagnosis of metastatic tumors of pancreas from RCC was 63 years old (58-77). The median interval time after nephrectomy was 104 months (39-189). A case with metastatic tumors of pancreas from thymic carcinoma was diagnosed simultaneously with its primary malignancy. 4 of 6 cases from RCC had multiple metastatic focuses in pancreas. The rest including the case from thymic carcinoma had single metastatic focus. Operative procedures were distal pancreatectomy (4 cases, one of these cases had recurrence in the remnant pancreas and underwent total pancreatectomy 12 months after distal pancreatectomy), total pancreatectomy (2 cases) and pancreaticoduodenectomy (1 case). The median survival time after pancreas surgery of cases from RCC is 87 months (8-111). 3 cases from RCC had recurrence 3, 6 and 10 months after pancreas surgery respectively. But they are receiving chemotherapy and still surviving for 98, 8 and 56 months. Thymic carcinoma case had recurrence 2 months after pancreas surgery. Conclusion: It is known that most common secondary malignancy of pancreas is RCC. Since the prognosis of metastatic tumors of pancreas from RCC without extra-pancreatic metastasis is relatively good, surgical resection is recommended. But when it occurs from other primary malignancy, surgical indication should be determined considering its pathological and clinical character.