Systematic Reviews
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2018; 10(8): 211-220
Published online Aug 15, 2018. doi: 10.4251/wjgo.v10.i8.211
Pancreatic, periampullary and biliary cancer with liver metastases: Should we consider resection in selected cases?
Rachael Chang Lee, Harsh Kanhere, Markus Trochsler, Vy Broadbridge, Guy Maddern, Timothy J Price
Rachael Chang Lee, Vy Broadbridge, Timothy J Price, Department of Medical Oncology, the Queen Elizabeth Hospital, Adelaide 5011, Australia
Harsh Kanhere, Markus Trochsler, Guy Maddern, Department of Surgery, the Queen Elizabeth Hospital, Adelaide 5011, Australia
Harsh Kanhere, Markus Trochsler, Guy Maddern, Timothy J Price, School of Medicine, University of Adelaide, Adelaide 5000, Australia
Author contributions: All authors made substantial contributions to the conception of the article, analysis and interpretation of data, revision of the article critically for important intellectual content and have given final approval of the version to be submitted and any revised version; all authors have participated sufficiently in the work to take public responsibility for appropriate portions of the content.
Conflict-of-interest statement: All authors have nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Timothy J Price, FRACP, MBBS, MD, Professor, Department of Medical Oncology, the Queen Elizabeth Hospital, 28 Woodville Road, Adelaide 5011, Australia.
Telephone: +61-8-82228429
Received: April 15, 2018
Peer-review started: April 16, 2018
First decision: May 9, 2018
Revised: May 14, 2018
Accepted: June 27, 2018
Article in press: June 28, 2018
Published online: August 15, 2018

To analyse the safety and efficacy of curative intent surgery in biliary and pancreatic cancer.


An extensive literature review was performed using MEDLINE, Google Scholar and EMBASE to identify articles regarding hepato-pancreatoduodenectomy or resection of liver metastasis in patients with pancreatic, biliary tract, periampullary and gallbladder cancers.


A total of 19 studies were identified and reviewed. Major hepatectomy was undertaken in 391 patients. The median overall survival for pancreatic cancer ranged from 5-36 mo and for biliary tract/gallbladder cancer, it was 8-38 mo. The 30 d mortality rate was only 1%-9%. Overall Survival was significantly better for patients, who had good response to neoadjuvant chemotherapy, underwent metachronous liver resection and who had intestinal type tumours.


Resection of liver metastases in pancreatic and biliary cancers may provide survival benefit without compromising safety and quality of life in a very select group of patients. These data may be utilised to formulate selection criteria that may allow future investigation of resection in the era of more effective systemic therapy.

Keywords: Pancreas, Liver resection, Gall bladder, Cholangiocarcinoma, Review

Core tip: Hepatic resection may be feasible for highly selected pancreatic and biliary tract cancer patients with a propensity towards improved outcomes and provide a chance for long term survival. The longer disease free interval between primary tumour and the liver metastases, response to the neoadjuvant treatment and other prognostic markers may also facilitate better selection of patients with more favourable tumour biology and prognosticate individual patient.