TY - JOUR
T1 - Pulmonary Resection for Isolated Pancreatic Adenocarcinoma Metastasis
T2 - An Analysis of Outcomes and Survival
AU - Arnaoutakis, George J.
AU - Rangachari, Deepa
AU - Laheru, Daniel A.
AU - Iacobuzio-Donahue, Chris A.
AU - Hruban, Ralph H.
AU - Herman, Joseph M.
AU - Edil, Barish H.
AU - Pawlik, Timothy M.
AU - Schulick, Richard D.
AU - Cameron, John L.
AU - Meneshian, Avedis
AU - Yang, Stephen C.
AU - Wolfgang, Christopher L.
N1 - Funding Information:
Acknowledgment This research was supported in part by National Institutes of Health Grant 1T32CA126607-01A2 (GJA).
PY - 2011/9
Y1 - 2011/9
N2 - Objectives: This study was conducted to determine if pulmonary metastasectomy (PM) for isolated pancreatic cancer metastases is safe and effective. Methods: This was a retrospective case-control study of patients undergoing PM at our institution from 2000 to 2009 for isolated lung metastasis after resection for pancreatic cancer. Clinical and pathologic data were compared with a matched reference group. Resected neoplasms were immunolabeled for the Dpc4 protein. Kaplan-Meier analysis compared overall survival and survival after relapse. Results: Of 31 patients with isolated lung metastasis, 9 underwent 10 pulmonary resections. At initial pancreas resection, all patients were stage I or II. Other baseline characteristics were similar between the two groups. Median time from pancreatectomy to PM was 34 months (interquartile range 21-49). During the study, 29/31(90. 6%) patients died. There were no in-hospital mortalities or complications after PM. Median cumulative survival was significantly improved in the PM group (51 vs. 23 months, p = 0. 04). There was a trend toward greater 2-year survival after relapse in the PM group (40% vs. 27%, p = 0. 2). Conclusions: In patients with isolated lung metastasis from pancreatic adenocarcinoma, this is the first study to show that pulmonary resection can be performed safely with low morbidity and mortality. The improved survival in the PM group may result in part from selection bias but may also represent a benefit of the procedure.
AB - Objectives: This study was conducted to determine if pulmonary metastasectomy (PM) for isolated pancreatic cancer metastases is safe and effective. Methods: This was a retrospective case-control study of patients undergoing PM at our institution from 2000 to 2009 for isolated lung metastasis after resection for pancreatic cancer. Clinical and pathologic data were compared with a matched reference group. Resected neoplasms were immunolabeled for the Dpc4 protein. Kaplan-Meier analysis compared overall survival and survival after relapse. Results: Of 31 patients with isolated lung metastasis, 9 underwent 10 pulmonary resections. At initial pancreas resection, all patients were stage I or II. Other baseline characteristics were similar between the two groups. Median time from pancreatectomy to PM was 34 months (interquartile range 21-49). During the study, 29/31(90. 6%) patients died. There were no in-hospital mortalities or complications after PM. Median cumulative survival was significantly improved in the PM group (51 vs. 23 months, p = 0. 04). There was a trend toward greater 2-year survival after relapse in the PM group (40% vs. 27%, p = 0. 2). Conclusions: In patients with isolated lung metastasis from pancreatic adenocarcinoma, this is the first study to show that pulmonary resection can be performed safely with low morbidity and mortality. The improved survival in the PM group may result in part from selection bias but may also represent a benefit of the procedure.
KW - Metastasectomy
KW - Metastatic adenocarcinoma
KW - Pancreatic adenocarcinoma
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U2 - 10.1007/s11605-011-1605-8
DO - 10.1007/s11605-011-1605-8
M3 - Article
C2 - 21725701
AN - SCOPUS:80051928519
SN - 1091-255X
VL - 15
SP - 1611
EP - 1617
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 9
ER -