Brain Metastasis in Pancreatic Cancer

Johannes Lemke,Christian Wirtz,Marko Kornmann,Jan Scheele,Thomas Kapapa,Doris Henne-Bruns

doi:10.3390/ijms14024163

Johannes Lemke, Christian Wirtz + Show 4 more

Open Access

https://doi.org/10.3390/ijms14024163

Copy DOI

Abstract

Pancreatic cancer is a fatal disease with a 5-year survival rate below 5%. Most patients are diagnosed at an advanced tumor stage and existence of distant metastases. However, involvement of the central nervous system is rare in pancreatic cancer. We retrospectively analyzed all cases of brain metastases in pancreatic cancer reported to date focusing on patient characteristics, clinical appearance, therapy and survival. Including our own, 12 cases of brain metastases originating from pancreatic cancer were identified. In three patients brain metastases were the first manifestation of pancreatic cancer. All other patients developed brain metastases during their clinical course. In most cases, the disease progressed rapidly and the patients died within weeks or months. However, two patients showed long-term survival. Of note, both patients received resection of the pancreatic cancer as well as curative resection of the metachronous brain metastases. Brain metastases in pancreatic cancer are a rare condition and usually predict a very poor prognosis. However, there is evidence that resection of brain metastases of pancreatic cancer can be immensely beneficial to patient’s survival, even with the chance for cure. Therefore, a surgical approach in metastatic pancreatic cancer should be considered in selective cases.

Highlights

Around 44,000 new cases of pancreatic cancer are estimated to have occurred in the US in 2012, a relatively rare cancer entity compared to other malignancies of the gastrointestinal tract [1]
In summary we conclude that brain metastases originating from pancreatic cancer are rare and usually associated with impaired survival
We recently reported on two patients that underwent curative resection for primary pancreatic cancer and developed metachronous, symptomatic brain metastasis

Summary

Introduction

Around 44,000 new cases of pancreatic cancer are estimated to have occurred in the US in 2012, a relatively rare cancer entity compared to other malignancies of the gastrointestinal tract [1]. The survival rate has not changed during recent decades, despite tremendous advances in cancer diagnostic and therapy This can be attributed to the fact that the only chance for cure is the complete surgical resection of the tumor, which, can only be performed in about 20% of all patients diagnosed [2]. The incidence of brain metastasis is about 4% in colorectal and below 1% in gastric cancer [12,13,14] In both cases brain metastases are known to predict a very poor survival [15,16]. We systematically reviewed all reported cases of brain metastases originating from pancreatic cancer focusing on patient characteristics, clinical appearance, therapy and outcome

Brain Metastasis in Pancreatic Cancer

Discussion

Findings

Materials and Methods

Conclusions