Analysis of 5 patients with isolated lung metastases after resection of pancreatic cancer

Abstract

Although the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) with postoperative recurrence is poor, lung metastases may have a relatively better prognosis than other sites of recurrence. Among 112 patients who underwent surgery for PDAC in our department between 2006 and 2017, 5 had recurrence in the lung alone, and 3 underwent resection of the lung metastases. All 5 patients were male, and the 2 who did not undergo resection of the lung metastases included one with unresectable multiple lung lesions and one with respiratory dysfunction. Primary tumor resection was performed after preoperative adjuvant chemotherapy in all 5 patients, and postoperative adjuvant chemotherapy was given to 4 patients. Pathologically, 4 had lymph node metastases, and an R0 resection was performed in 4 patients. Regardless of the presence of lung metastasis, all 5 patients have an overall survival more than 4 years, and only one patient died due to the lung metastases. There are many reports that resection of lung metastases in patients with pancreatic cancer improves their prognosis. However, it is necessary to accumulate and review more patients in future studies to show the effectiveness of metastasectomy.