The pancreas as a target for metastases of abdominal tumors

SANTIAGO RUBIO; FRANCISCO PATTIN; GABRIEL E. GONDOLESI; BARROS SCHELOTTO, PABLO; DIEGO RAMISCH; FARINELLI PABLO; HUGO PALADINI

MIAMI

Congreso; AHPBA 2018; 2018

Introduction: The pancreas is an uncommon site for metastases (MTS) of other tumors, accounting for 0.25% - 5% of pancreatic tumors, so that solitary pancreatic metastases are rare. The most frequent abdominal primary tumors capable to metastasize into the pancreas are Renal Cell Carcinoma (RCC), followed by Colorectal Cancer (CRC). Surgical resection remains as the best and only therapeutic alternative to achieve long term survival (51 to 88% at 5 years). Our aim is to present the long-term results of pancreatic resection due a pancreatic MTS. Methods: this is a retrospective analysis of adult patients (pts) operated for pancreatic MTS of abdominal tumors at HUFF from 07/2010 to 09/2017. Results: During the studied period 158 pts received pancreatic surgery, 9 (5.6%) pts had pancreatic MTS, 6 MTS of RCC and 3 of CRC. The mean age was 58±12 years and 56% were female. The mean free disease survival was 6.7±7.2 years, 1 pts had synchronic pancreatic MTS. The mean number of pancreatic lesions was 1.5; 7 distal pancreatectomies, 1 total pancreatectomy and 1 pancreatoduodenectomy were performed. One patient required vascular resection. Four patients had post-surgical complications (2 Dindo-Clavien I, 1 Dindo-Clavien IVA and 1 Dindo-Clavien V). At a median follow-up of 48 months, the overall 1, 3 and 5 years survival was 89%, 67% and 33%. Conclusion: Although pancreatic MTS are a rare finding, resection offers the best oncological alternative and need to be consider in patients with past medical history of RCC or CRC. CaseAge (y)/sexType of MTSInterval (y)LocalizationN˚OPSurvival(m)/Current StatusPt 153/MRCC/RK17Body1dP48/DeceasedPt 265/MRCC/RK2Body1dP39/AlivePt 344/FRCC/RKSynchronicHead1PD27/AlivePt 452/MRCC/LK12Head, Body and Tail3tP16/AlivePt 582/FRCC/LK0.3Body1dP12/AlivePt 660/MRCC/RK17Body and Tail6dP2/AlivePt 747/FCRC1Body and Tail2dP32/DeceasedPt 850/FCRC1Body1dP65/AlivePt 966/FCRC10Body1dP0.5/DeceasedTable 1. Summary description of patients. RCC: Renal Cell Carcinoma, CRC: Colorectal Cancer, RK: Right Kidney, LK: Left Kidney, dP: distal Pancreatectomy, tP: total Pancreatectomy, PD: Pancreatoduodenectomy.