title: Analysis of prognostic factors in metastatic tumors of the pancreas: a single-center experience and review of the literature.
abstract: OBJECTIVE
  Pancreatic metastases are rare. The role of surgery is poorly defined, and data on long-term survival are lacking.
  
  
  METHODS
  Data from patients with pancreatic metastases observed in our division from 2003 to 2008 were retrospectively analyzed. In addition, the recent English medical literature was reviewed regarding series of patients with pancreatic secondary tumors.
  
  
  RESULTS
  Data from 234 patients including 9 consecutive patients observed in our division were retrieved. Metastasis from renal cell carcinoma accounted for 67.9% of all cases. Factors predictive of worse survival, as determined by multivariate analysis, were symptoms at diagnosis, synchronous tumors, radical-intent surgery not performed, and pathologic diagnosis of the primary tumor. Compared with pancreatic metastases from renal cell cancer, metastases from melanoma (P < 0.001) and lung cancer (P = 0.002) were associated with worse survival. The differences in survival of patients with renal cell cancer metastases and those with breast cancer, colorectal, or sarcoma metastases did not reach statistical significance.
  
  
  CONCLUSIONS
  There may be a subset of patients with pancreatic metastases who are able to benefit from surgery with respect to improved long-term survival. Symptoms at diagnosis, presentation with primary tumor, surgical resection, and pathologic diagnosis seem to be important prognostic factors.
authors.affiliation: School of Medicine, University of Modena, Modena, Bologna, Italy. m.masetti@ausl.bologna.it
authors.forename: Michele
authors.initials: M
authors.lastname: Masetti
authors.forename: Nicola
authors.initials: N
authors.lastname: Zanini
authors.forename: Federica
authors.initials: F
authors.lastname: Martuzzi
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.forename: Laura
authors.initials: L
authors.lastname: Mastrangelo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landolfo
authors.forename: Adele
authors.initials: A
authors.lastname: Fornelli
authors.forename: Marcellino
authors.initials: M
authors.lastname: Burzi
authors.forename: Elena
authors.initials: E
authors.lastname: Vezzelli
authors.forename: Elio
authors.initials: E
authors.lastname: Jovine
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome