Pancreatic resection for locally advanced primary and metastatic nonpancreatic neoplasms

James F. Pingpank, John P. Hoffman, Elin R. Sigurdson, Eric Ross, Aaron R. Sasson, Burton L. Eisenberg

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

We conducted a retrospective review of our single-institution experience with pancreas resection for locally advanced primary malignancy or metastases from other organs. From January 1989 through April 2001 35 patients underwent pancreatic resection for locally advanced primary (17) and recurrent nonpancreatic (18) tumors. Patient records were examined for recurrence and survival. Seventeen patients with locally advanced primary tumors presented with pancreatic extension either into the head/body (six) or tail (11). Pancreatic resections were completed as en bloc procedures with the primary disease of stomach (five), colon (four), sarcoma (five), adrenal gland (one), or spleen (one). Procedures performed included pancreaticoduodenectomy for proximal lesions and distal pancreatectomy for disease limited to the pancreatic tail. Median overall survival was 56 months. Fourteen of 17 patients remain alive: three with disease and 11 without evidence of recurrence. Eighteen patients presented with recurrent tumor from a previously resected right upper quadrant tumor (nine) or metastases from an intra-abdominal source (nine). The primary source was colon (eight), biliary (three), sarcoma (three), melanoma (two), ovary (one), and unknown primary (one). Patients underwent pancreaticoduodenectomy, distal pancreatectomy, or resection of residual pancreas. Overall median survival was 46 months. In this group of 18 patients there was no increased survival in those patients with a time to recurrence from their primary tumor resection greater than 2 years. We conclude that pancreatic resection for locally advanced nonpancreatic or recurrent intra-abdominal malignancies is possible in properly selected patients. The ability to obtain disease-free margins through en bloc resection is a key component of therapy.

Original languageEnglish (US)
Pages (from-to)337-340
Number of pages4
JournalAmerican Surgeon
Volume68
Issue number4
StatePublished - 2002
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Pingpank, J. F., Hoffman, J. P., Sigurdson, E. R., Ross, E., Sasson, A. R., & Eisenberg, B. L. (2002). Pancreatic resection for locally advanced primary and metastatic nonpancreatic neoplasms. American Surgeon, 68(4), 337-340.