title: Metastases of pancreatic adenocarcinoma: A systematic review of literature and a new functional concept.
abstract: BACKGROUND
  Pancreatic cancer, especially Pancreatic Adenocarcinoma, is still associated with a high mortality and morbidity for affected patients notwithstanding considerable progresses in diagnosis and both surgical pharmacological therapy. Despite metastases from colorectal, gastric and neuroendocrine primary tumor and their treatment are widely reported, the literature has been rarely investigated the impact of localization and numbers of pancreatic metastases. This study performed a systematic analysis of the most recent scientific literature on the natural history of Pancreatic Adenocarcinoma focusing attention on the role that the "M" parameter has on a possible prognostic stratification of these patients.
  
  
  METHODS
  PubMed and Science Direct databases were searched for relevant articles on these issue.
  
  
  RESULTS
  Initial database searches yielded 7231 studies from PubMed and 29101 from Science Direct. We evaluated 1031 eligible full text articles.
  
  
  CONCLUSIONS
  An updated insight into the world of Pancreatic Tumors might help physicians in better evaluating mechanisms of metastases, patients selection and survival and in programming appropriate interventions to modify the worst outcomes of advanced disease.
authors.affiliation: Department of Surgery, Annunziata Hospital of Cosenza, Cosenza, Italy. Electronic address: anubis_m@libero.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Cannistrà
authors.affiliation: Department of Surgery, Annunziata Hospital of Cosenza, Cosenza, Italy. Electronic address: ruggant@alice.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Ruggiero
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Italy. Electronic address: alessandra.zullo@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zullo
authors.affiliation: Department of Surgery, Annunziata Hospital of Cosenza, Cosenza, Italy. Electronic address: seraf87@gmail.com.
authors.forename: Simone
authors.initials: S
authors.lastname: Serafini
authors.affiliation: Department of Medical and Surgical Sciences, University of Catanzaro, Italy. Electronic address: raffaele.eia@alice.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Grande
authors.affiliation: Department of Surgery, Annunziata Hospital of Cosenza, Cosenza, Italy; Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Italy. Electronic address: bruno.nardo@unibo.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Nardo
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D011379:Prognosis
keywords: Pancreatic adenocarcinoma; Pancreatic metastases; Prognostic factors; Surgery