title: Long-Term Outcomes of 98 Surgically Resected Metastatic Tumors in the Pancreas.
abstract: OBJECTIVE
  The goal of this study was to assess the outcomes and characteristics of patients who underwent pancreatectomy for metastatic disease to the pancreas.
  
  
  METHODS
  Patients who underwent surgical resection of metastatic disease to the pancreas from 1988 to 2016 were identified using a prospectively maintained database. Data on clinicopathological features and outcomes of these patients were analyzed. Cox proportional hazard models were employed to identify patient-specific risk factors that influence survival.
  
  
  RESULTS
  Ninety-seven patients underwent 98 pancreatic metastasectomies from July 1988 through March 2016 for metastatic disease from 13 different primary cancers. Pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy were performed in 49 (50 %), 37 (38 %), and 12 (12 %) patients, respectively. Postoperative complications occurred in 55 (56 %) patients, while 3 (3 %) perioperative deaths occurred. Median follow-up was 2.0 years, with a median survival of 3.2 years. Multivariate analysis revealed that older patients [hazard ratio (HR) 1.04/year; p = 0.006], non-renal cell carcinomas (HR 5.07; p < 0.001), vascular invasion (HR 3.53; p < 0.001), and positive resection margins (HR 2.62; p = 0.008) were independently associated with an increased risk of mortality.
  
  
  CONCLUSIONS
  Pancreatic metastasectomy is safe and feasible in well-selected patients and is associated with acceptable long-term survival.
authors: Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
authors: Shin-Rong
authors: SR
authors: Lee
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Georgios
authors: G
authors: Gemenetzis
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Michol
authors: M
authors: Cooper
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Ammar A
authors: AA
authors: Javed
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: John L
authors: JL
authors: Cameron
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Christopher L
authors: CL
authors: Wolfgang
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Frederick E
authors: FE
authors: Eckhauser
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Jin
authors: J
authors: He
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. mweiss5@jhmi.edu.
authors: Matthew J
authors: MJ
authors: Weiss
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors