Metastasis to the pancreas from colorectal cancer: is there a place for pancreatic resection?
OBJECTIVE
Pancreatic metastases from colorectal cancer are very rare, and the possible benefit of surgical treatment is not clearly defined. This study was designed to evaluate the outcome of patients undergoing pancreatic resection for metastatic colorectal cancer to the pancreas.


METHODS
Nine patients underwent pancreatic resection for metastatic colorectal cancer between January 1980 and December 2006. The primary cancers were colon (n = 7) and rectal carcinoma (n = 2). The median interval between primary treatment and detection of pancreatic metastases was 32.5 months. In three cases pancreatic metastases were synchronous with the primary tumor.


RESULTS
Five patients underwent pancreaticoduodenectomy, and four underwent distal pancreatectomy. A left lateral liver section and three colon resections were simultaneously performed in four patients. There was no postoperative mortality, and only two patients experienced complications. Survival averaged 19.8 (median, 17.0; range, 5-30) months: seven patients died of metastatic disease, one for unrelated disease after five months, and one is alive with liver metastases 30 months after surgery.


CONCLUSIONS
Surgical resection can be performed safely in patients with isolated pancreatic metastases from colorectal cancer and in selected patients with associated extrapancreatic disease. Although long-term survival is rare, surgery should be included, whenever possible, in the multimodality approach to this disease.
Sperti
Cosimo
C
Department of Medical and Surgical Sciences, Clinica Chirurgica IV, University of Padua, Padova, Italy. csperti@libero.it
Pasquali
Claudio
C
Berselli
Mattia
M
Frison
Laura
L
Vicario
Giovanni
G
Pedrazzoli
Sergio
S
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods; D011183:Postoperative Complications; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome