Metastatic tumors to the pancreas: The role of surgery

Abstract

Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature’s analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative.

Keywords: Pancreas, Pancreatic neoplasms/secondary, Pancreatectomy, Renal cell cancer, Breast cancer, Melanoma, Sarcoma, Lung carcinoma

Core tip: Pancreatic metastases represent a rare but increasing entity among pancreatic tumors. We have reviewed the literature’s reports of the more common metastatic tumors to the pancreas, evaluating early and long-term results of surgery. Pancreatic resection may appear a safe and feasible option also in metastatic tumors, but long term survival is achieved substantially only in renal cell cancer. In other metastatic tumors, pancreatectomy may offer a good palliation in selected patients, but it is to remark that surgery is only one option in the multimodality treatment of metastatic disease to the pancreas.