Outcomes of surgical resection in the management of colorectal pancreatic metastases.

Abstract

CONTEXT:

Colorectal pancreatic metastases (CRPM) are uncommon, thus the role of surgical resection is unclear. We present our experience of management outcomes of patients with CRPM in a regional pancreatic unit.

METHODS:

Electronic records of all patients with colorectal cancer (n = 8,228) held by the cancer network were searched for evidence of CRPM. Retrospective analysis of each case was undertaken in relation to diagnosis, management and outcome of CRPM.

RESULTS:

Four cases of CRPM underwent resection (operative group). The interval between diagnosis of colorectal carcinoma and CRPM was 1, 6, 7 and 7 years. CRPM were identified on routine CT surveillance in asymptomatic patients. An additional 5 patients were managed palliatively (non-operative group). In the surgical cohort, median survival was 4 years. One patient remains disease free 4 years 3 months post-surgery. Of 3 patients with recurrent disease, 1 is alive with progressive disease 3 years 11 months post-operatively and 2 passed away at 18 months and 5 years 1 month respectively. Median survival in the palliative group from diagnosis of CRPM was 11 months.

CONCLUSIONS:

In selected patients with CRPM surgical resection does confer survival benefit. CRPM arise late in the disease course, with extra-pancreatic metastases frequently diagnosed in the interim. Surgeons outside of pancreatic units should refer cases to their local pancreatic multi-disciplinary team meeting for consideration of resection.

• Authors: Shahid G Farid, Lara Morley, Keith J Roberts, Gareth Morris-Stiff, Andrew M Smith
• Journal: JOP : Journal of the pancreas (JOP) Vol. 15 Issue 5 Pg. 442-7 (Sep 28 2014) ISSN: 1590-8577 [Electronic] Italy
• PMID: 25262710 (Publication Type: Journal Article)