Efficacy of liver metastasectomy in pancreatic cancer

Abstract

Background: Standard treatment for metastatic pancreatic cancer is systemnic chemotherapy. Significance of liver metastasectomy in pancreatic cancer remains unknown. This study aims to investigate efficacy of liver metastasectomy in pancreatic cancer. Methods: Between 2001 and 2019, 14 cases who underwent liver metastasectomy for pancreatic cancer at Tohoku University Hospital, including 7 synchronous metastasis cases and 7 metachronous metastasis cases, were retrospectively investigated. Results: Synchronous metastasis: Simultaneous resection of primary pancreatic tumor and liver metastases was performed in 5 cases, including 4 cases with neoadjuvant therapy and one cases with upfront surgery. Two-stage resection, which means prior metastasectomy and subsequent resection of primary tumor after chemotherapy, was performed in 2 cases. The number of metastatic tumors was within 3 in 6 cases. Median survival time (MST) after surgery, which was calculated from the primary tumor resection date in two-stage resection, was 12.5 months. One case with two-stage resection has been alive without recurrence for 81 months after surgery. Metachronous metastasis: The median time between primary tumor resection and liver metastases was 10.7 months. All cases were treated with systemic chemotherapy before liver metastasectomy. Duration of chemotherapy before metastasectomy was 3 months in 1 case, 6-12 months in 4 cases, and 12-24 months in 2 cases. The number of metastatic tumors was within 2 in all cases. MST after metastasectomy was 19.8 months. Conclusion: There are cases who has benefit of metastasectomy in liver metastasis of pancreatic cancer.