SpringerLink
Log in

Metastasen im Pankreas

Wann ist eine Resektion sinnvoll?

Metastatic lesions to the pancreas

When is resection reasonable?

  • Originalien
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Der Stellenwert der Resektion von Pankreasmetastasen ist bisher nicht hinreichend untersucht. Wir untersuchten unser Patientengut nach Pankreasresektionen bei Metastasen im Pankreas retrospektiv hinsichtlich des klinischen Verlaufes und des Langzeitüberlebens.

Methode

Zwanzig Patienten wurden aufgrund von metastatischen Raumforderungen im Pankreas reseziert: Nierenzellkarzinom (n=9), Sigmakarzinom (n=1), malignes Schwannom (n=2), Leiomyosarkom (n=2) Teratokarzinom (n=1), Ösophaguskarzinom (n=1), Gallenblasenkarzinom (n=1), malignes Melanom (n=1), gastrointestinaler Stromatumor (n=1) sowie spindelzelliger mesenchymaler Tumor (n=1). Bei 6 Patienten wurde eine partielle Duodenopankreatektomie (Kausch-Whipple) durchgeführt, bei weiteren 6 eine pyloruserhaltende Pankreaskopfresektion. Acht Patienten erhielten eine Pankreaslinksresektion mit Splenektomie.

Ergebnis

Das 5-Jahres-Überleben für alle Patienten lag bei 61%, für Patienten mit Nierenzellkarzinom bei 100%.

Schlussfolgerung

Resektionen von Metastasen im Pankreas können bei ausgewählten Patienten eine sinnvolle Therapieoption darstellen. Patienten mit Hypernephrommetastasen zeigen dabei nach Ausschluss weiterer Metastasen nach radikaler Resektion eine exzellente Prognose.

Abstract

Background

The significance of pancreatic resection for pancreatic metastatic lesions has not yet been sufficiently investigated. A retrospective analysis of patients undergoing pancreatic resections for pancreatic metastases was conducted.

Material and Methods

Twenty patients were resected due to metastatic lesions to the pancreas. Histopathological findings were: renal cell carcinoma (n=9), colon carcinoma (n=1), malignant schwannoma (n=2), leiomyosarcoma (n=2), teratocarcinoma (n=1), adenocarcinoma of the oesophagus (n=1), gallbladder carcinoma (n=1), malignant melanoma (n=1), gastrointestinal stromal tumor (n=1), and spindle cell tumor (n=1). Operative procedures were standard pancreaticoduodenectomy (n=6), pylorus-preserving pancreaticoduodenectomy (n=6), and distal pancreatectomy (n=8).

Result

The overall 5-year survival rate was 61%, for patients with renal cell carcinoma 100%.

Conclusion

Pancreatic metastasectomy is a reasonable therapeutic option in suited patients. Patients with pancreatic metastases of renal cell carcinoma achieved excellent prognoses after radical resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Adsay NV, Andea A, Basturk O et al. (2004) Secondary tumors of the pancreas: An analysis of a surgical and autopsy database and review of the literature. Virchows Arch 444: 527–535

    Article  PubMed  Google Scholar 

  2. Benning TL, Silvermann JF, Berns LA, Geisinger KR (1992) Fine needle aspiration of metastastic and hematologic malignancies clinically mimicking pancreatic carcinoma. Acta Cytol 36: 471–476

    PubMed  CAS  Google Scholar 

  3. Brodisch RJ, McFadden DW (1993) The pancreas as the solitary site of metastasis from melanoma. Pancreas: 276–278

  4. Crippa S, Angelini C, Mussi C et al. (2006) Surgical treatment of metastatic tumors to the pancreas: A single center experience and review of the literature. World J Surg 30: 1536–1542

    Article  PubMed  Google Scholar 

  5. Hirato T, Tomida T, Isawa M et al. (1996) Solitary pancreatic metastasis occuring eight years after nephrectomy for renal cell carcinoma. A case report andsurgical review. Int J Pancreatol

  6. Jonas S, Thelen A, Benckert C et al. (2007) Extended resections of liver metastases from colorectal cancer. World J Surg 31: 511–521

    Article  PubMed  CAS  Google Scholar 

  7. Klein AK, Stephens DH, Wech TJ (1998) CT-characteristics of metastatic disease of the pancreas. Radiographics 18: 369–378

    PubMed  CAS  Google Scholar 

  8. Klöppel G (ed) (1984) Pancreatic pathology. Churchill Livingstone, Edinburgh, p 108

  9. Le Borgne J, Partensky C, Glemain P (2000) Pancreaticoduodenectomy for non-periampullary tumors. Hepatogastroenterology 47: 540–544

    Google Scholar 

  10. Martin R, Paty P, Fong Y et al. (2003) Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis. J Am Coll Surg 197: 233–241; discussion 241–232

    Article  PubMed  Google Scholar 

  11. Nakamura E, Shimizu M, Itho T, Manabe T (2001) Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases in Japanese patients. Pathol Int 51: 686–690

    Article  PubMed  CAS  Google Scholar 

  12. Roland CF, Heerden JA van (1989) Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet 168: 345–347

    PubMed  CAS  Google Scholar 

  13. Abrams HL, Spiro R, Goldstein N (1950) Metastases in carcinoma: Analysis of 1000 autopsied cases. Cancer 3: 74–85

    Article  PubMed  CAS  Google Scholar 

  14. Schafer M, Mullhaupt B, Clavien PA (2002) Evidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis. Ann Surg 236: 137–148

    Article  PubMed  Google Scholar 

  15. Sotiropoulos GC, Lang H, Liu C et al. (2005) Surgical treatment of pancreatic metastases of renal cell carcinoma. JOP 6: 339–343

    PubMed  Google Scholar 

  16. Sperti C, Pasquali C, Liessi G et al. (2003) Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol 83: 161–166; discussion 166

    Article  PubMed  Google Scholar 

  17. Thompson LD, Heffess CS (2000) Renal cell carcinoma to the pancreas in surgical pathology material. Cancer 89: 1076–1088

    Article  PubMed  CAS  Google Scholar 

  18. Trede M (1994) Technik der Duodenopankreatektomie nach Whipple. Chirurg 65: 232–240

    PubMed  CAS  Google Scholar 

  19. Yeo CJ, Cameron JL, Sohn TA et al. (1997) Six hundred fifty consecutive pancreaticoduodenectomies in the 1990 s. Pathology, complications, and outcomes. Ann Surg: 248–260

    Google Scholar 

  20. Zerbi A, Balzano G, Patuzzo R et al. (1995) Comparison between pylorus-preserving and Whipple pancreatoduodenectomy. Br J Surg 82: 975–979

    Article  PubMed  CAS  Google Scholar 

  21. Z’Graggen K, Fernandez-del Castillo C, Rattner DW et al. (1998) Metastases to the pancreas and their surgical extirpation. Arch Surg 133: 413–417; discussion 418–419

    Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    M. Bahra, D. Jacob, J.M. Langrehr, M. Glanemann, G. Schumacher & P. Neuhaus

  2. Klinik für Strahlenheilkunde, Charité-Universitätmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland

    E. Lopez-Hänninen

Authors
  1. M. Bahra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Jacob
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J.M. Langrehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Glanemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Schumacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Lopez-Hänninen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Neuhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Bahra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bahra, M., Jacob, D., Langrehr, J. et al. Metastasen im Pankreas. Chirurg 79, 241–248 (2008). https://doi.org/10.1007/s00104-007-1390-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-007-1390-9

Schlüsselwörter

Keywords

Search

Navigation