Document Detail


Pulmonary resection for isolated pancreatic adenocarcinoma metastasis: an analysis of outcomes and survival.
MedLine Citation:
PMID:  21725701     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
George J Arnaoutakis; Deepa Rangachari; Daniel A Laheru; Chris A Iacobuzio-Donahue; Ralph H Hruban; Joseph M Herman; Barish H Edil; Timothy M Pawlik; Richard D Schulick; John L Cameron; Avedis Meneshian; Stephen C Yang; Christopher L Wolfgang
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-07-02
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  15     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-23     Completed Date:  2012-01-23     Revised Date:  2014-08-25    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1611-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / chemistry,  secondary,  surgery*
Aged
Case-Control Studies
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Lung Neoplasms / chemistry,  secondary,  surgery*
Male
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms / chemistry,  pathology*,  surgery
Retrospective Studies
Smad4 Protein / analysis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
1T32CA126607-01A2/CA/NCI NIH HHS; P30 CA006973/CA/NCI NIH HHS; P50 CA101955/CA/NCI NIH HHS; T32 CA126607/CA/NCI NIH HHS; T32 CA126607-01A2/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/SMAD4 protein, human; 0/Smad4 Protein
Comments/Corrections

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