Pancreatic metastases: a multicentric study of 22 patients.
OBJECTIVE
To evaluate the diagnosis, treatment and outcome of patients with pancreatic metastases.


METHODS
We retrospectively reviewed the records of patients with pancreatic metastasis managed in the Paris area between 1990 and 2000.


RESULTS
The series analyzed included 22 patients, 10 men and 12 women, mean age 61 years (range: 35-76). The primary tumors were renal-cell carcinoma (N=10), colorectal cancer (N=4), lung cancer (N=4), breast cancer (N=2), cutaneous melanoma (N=1) and ileal carcinoid (N=1). The mean interval between primary treatment and presentation was 73.5 months (range: 2-151). Diagnosis was established because of clinical symptoms (N=15) or during surveillance (N=7). Computed tomography (N=19) and endoscopic ultrasound (EUS) (N=18) mainly showed solitary and hypodense/or hypoechoic masses. Histological diagnosis was obtained before surgery by EUS-guided fine needle aspiration (N=6), ultrasound-guided biopsy (N=3) or duodenoscopy (N=3). Among 10 patients with primary renal-cell carcinoma, 7 were treated by surgery. Median global survival was 33 months. Median survival was 61 months in the event of surgical treatment and 20 months in the other patients (ns). Mean survival depended on the type of primary tumor, 61 months for renal-cell carcinoma and 33 for colorectal cancer (P=0.06).


CONCLUSIONS
Most pancreatic metastases develop from renal-cell carcinoma and can occur several years after nephrectomy. Histological diagnosis is often obtained before surgery. Surgical resection must be discussed as it can allow long-term survival.
Moussa
Abdallah
A
Service d'Hépato-Gastroentérologie et d'Oncologie Digestive, Hôpital Ambroise Paré, Boulogne Billancourt.
Mitry
Emmanuel
E
Hammel
Pascal
P
Sauvanet
Alain
A
Nassif
Tania
T
Palazzo
Laurent
L
Malka
David
D
Delchier
Jean-Charles
JC
Buffet
Catherine
C
Chaussade
Stanislas
S
Aparicio
Thomas
T
Lasser
Philippe
P
Rougier
Philippe
P
Lesur
Gilles
G
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000601:surgery*; D010297:Paris; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors