title: Resection of oligometastatic lung cancer to the pancreas may yield a survival benefit in select patients--a systematic review.
abstract: OBJECTIVE
  To conduct a systematic review of the existing literature regarding surgical therapy for oligometastatic lung cancer to the pancreas.
  
  
  METHODS
  Data was collected on patients with singular pancreatic metastases from lung cancer from papers published between January 1970 and June 2014. This was performed following the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. Kaplan-Meier and Cox Regression analyses were then used to determine and compare survival.
  
  
  RESULTS
  There were 27 papers that fulfilled the search criteria, from which data on 32 patients was collected. Non-small cell lung cancer (NSCLC) was the most prevalent type of primary lung malignancy, and metachronous presentations of metastases were most common. Lesions were most frequently located in the pancreatic head and consequently the most common curative intent metastasectomy was pancreaticoduodenectomy. There was a statistically significant survival benefit for patients whose metastasis were discovered incidentally by surveillance CT as opposed to those whose metastasis were discovered during a work up for new somatic complaints (p = 0.024). The overall median survival for patients undergoing curative intent resection was 29 months, with 2-year and 5-year survivals of 65% and 21% respectively. Palliative surgery or medical only management was associated with a median survival of 8 months and 2-year and 5-year survivals of 25% and 8% respectively.
  
  
  CONCLUSIONS
  Curative intent resection of isolated pancreatic metastasis from lung cancer may be beneficial in a select group of patients.
authors.affiliation: Department of Surgery, Yale-New Haven Hospital, New Haven, CT 06520, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: DeLuzio
authors.affiliation: Department of Surgery, Yale-New Haven Hospital, New Haven, CT 06520, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Moores
authors.affiliation: Department of Surgery, Morristown Medical Center, Morristown, NJ 07960, USA.
authors.forename: Ankit
authors.initials: A
authors.lastname: Dhamija
authors.affiliation: Division of Biostatistics, Yale School of Public Health, New Haven, CT 06520, USA.
authors.forename: Zuoheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Section of Surgical Oncology, Yale School of Medicine, New Haven, CT 06520, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Cha
authors.affiliation: Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT 06520, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Boffa
authors.affiliation: Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT 06520, USA.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Detterbeck
authors.affiliation: Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: anthony.kim@yale.edu.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Kim
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Curative; Lung; Metastasis; Oligometastasis; Pancreas; Resection