Abstract
BackgroundSurgical indications for liver metastases from pancreatic ductal adenocarcinoma (PDAC) are lacking because outcomes are usually poor. However, liver resection and the recent progress in perioperative chemotherapy have been observed to improve survival.MethodsWe performed liver resection for liver metastases from PDAC only under the following criteria: (1) liver-only metastasis, (2) up to three tumors, and (3) no increase in the number of metastases during the 3-month observation period. No limitations were placed on the location or size of liver metastasis. In this study, we aimed to validate our surgical criteria and analyze factors affecting survival in patients with PDAC.ResultsSeventy-nine patients underwent curative resection for PDAC between 2005 and 2015. Seventy-one patients experienced recurrence, with liver-only recurrence in 17 patients. Among these, nine patients underwent liver resection and eight did not. The median survival time was significantly better for patients who underwent liver resection (55 months) than for those with other recurrences (17.5 months, p = 0.016). The median survival after liver recurrence was significantly better in the liver resection group (31 months) than in the non-liver resection group (7 months, p = 0.0008). The median disease-free interval (DFI) after pancreatectomy was significantly longer in the liver resection group (21 months; range, 3–44 months) than in the non-liver resection group (3 months; range, 2–7 months; p = 0.02).ConclusionGood indications for liver metastases from PDAC include solitary metachronous tumors and longer DFIs.
Highlights
Pancreatic ductal adenocarcinoma (PDAC) has a high frequency of recurrence even after curative resection [1,2,3]
Deducing the surgical indications for the resection of liver metastases from each type of cancer has been difficult owing to the limited number of Mitsuka et al World Journal of Surgical Oncology (2020) 18:294 participants
Indications for liver resection When metachronous liver metastases were found in up to three tumors, liver resection was considered after a 3-month observation period
Summary
Pancreatic ductal adenocarcinoma (PDAC) has a high frequency of recurrence even after curative resection [1,2,3]. Advances in perioperative management have allowed liver resection for non-colorectal cancers [9, 10]. Deducing the surgical indications for the resection of liver metastases from each type of cancer has been difficult owing to the limited number of Mitsuka et al World Journal of Surgical Oncology (2020) 18:294 participants. Liver resection for PDAC has rarely been studied, and factors affecting survival have been poorly documented. Surgical indications for liver metastases from pancreatic ductal adenocarcinoma (PDAC) are lacking because outcomes are usually poor. Liver resection and the recent progress in perioperative chemotherapy have been observed to improve survival
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