title: Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection.
abstract: BACKGROUND
  Pancreatectomy has a high morbidity but remains the only chance of cure for pancreatic cancer. Its efficacy for non-pancreatic malignancies is less clear. We reviewed our experience with pancreatectomy for non-pancreatic malignancies to determine outcomes and identify predictors of survival.
  
  
  METHODS
  The records of patients who underwent pancreatectomy for non-pancreatic malignancies between 1990 and 2005 were reviewed. Survival curves were constructed using the Kaplan-Meier method and compared using log-rank analysis. Cox proportional hazards was used to identify predictors of survival.
  
  
  RESULTS
  29 patients (18 M/11 F) with a mean age of 59.9 years (range 29-86) underwent pancreatectomy for non-pancreatic malignancies. 19 (66%) primary malignancies were GI in origin. Most operations were undertaken with curative intent (76%), whereas the remainder was for symptom palliation. Pancreatectomy was completed for metastatic disease in 7 patients (24%) or en bloc to achieve negative margins in 22 patients (76%). Complete (i.e., R0) resection was achieved in 17 (59%). Perioperative mortality was 3%. Median follow-up was 15 months (range 7-172). Median overall survival was 12 months with 1-year survival of 48%. Significant predictors of improved survival by univariate analysis were R0 resection, non-GI primary, and pancreatic metastasectomy (vs. en bloc resection). Only R0 resection was predictive of long-term survival by multivariate analysis (median 21 months vs. 6).
  
  
  CONCLUSIONS
  Pancreatic resection for non-pancreatic malignancies can be completed with minimal mortality. However, incomplete resection results in poor overall survival. Pancreatectomy for non-pancreatic malignancies should only be undertaken if complete resection is possible.
authors.affiliation: Department of Surgery and Division of Surgical Oncology, The Ohio State University Medical Center, Columbus, OH, USA. Kimberly.Varker@osumc.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Varker
authors.forename: Peter
authors.initials: P
authors.lastname: Muscarella
authors.forename: Kristian
authors.initials: K
authors.lastname: Wall
authors.forename: Christopher
authors.initials: C
authors.lastname: Ellison
authors.forename: Mark
authors.initials: M
authors.lastname: Bloomston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010180:Pancreatectomy; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome