JKSS Journal of the Korean Surgical Society pISSN 2233-7903ㆍeISSN 2093-0488 J Korean Surg Soc 2011;80:278-282 DOI: 10.4174/jkss.2011.80.4.278 ORIGINAL ARTICLE Surgical resection of metastasis to the pancreas Dong Do You, Dong Wook Choi1, Seong Ho Choi1, Jin Seok Heo1, Woo Suk Kim1, Cheon Yu Ho 2 , Hyung Geun Lee1 Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, 1Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 2Hanil General Hospital, Seoul, Korea Purpose: Metastasis to the pancreas is rare, and the benefit of resection for pancreatic metastasis is poorly defined. The aim of this study was to review our experiences of the operative management of metastasis to the pancreas. Methods: Between 1995 and 2009, 11 patients (8 men and 3 women; median age, 54 years) were admitted to our institution with a metachronously metastatic lesion to the pancreas and later underwent pancreatic resection. The clinical features and outcomes of treatments were examined. Results: The primary cancers were renal cell carcinoma (RCC, n = 7), carcinoid tumor (n = 2), rectal cancer and leiomyosarcoma. Six patients underwent distal pancreatectosplenectomy, 3 pancreaticoduodenectomy and 2 patients underwent enucleation for small RCC. One patient died of metastatic RCC at 53 months after surgery and ten patients re- main alive; four patients without disease at 7 to 69 months postoperatively, and the other six with disease at 11 to 68 months. Median postoperative survival of all patients was 34 months. Conclusion: Patients with a low surgical risk should be consid- ered for pancreatic metastasectomy if curative resection is possible. Primary cancer type, which is associated with survival benefit, would be the best candidate for surgical resection of metastases to the pancreas. Key Words: Pancreatic metastasis, Pancreatic metastasectomy, Metastatic pancreatic cancer INTRODUCTION The vast majority of pancreatic tumors are primary, and metastatic tumors of the pancreas are rare, although direct invasion from advanced cancers in neighboring organs is sometimes observed. Metastatic tumors in autopsy series have been reported in from 3% to 11% [1,2]. Furthermore, the majority of patients with pancreatic metastasis have widespread disease [3]. Metastatic disease to the pancreas has been only infrequently diagnosed in living patients. Furthermore, although surgical resection of metastatic le- Received June 15, 2010, Accepted September 14, 2010 sions to the liver, lungs, and brain have been shown to im- prove survival and quality of life, the optimal manage- ment of pancreatic metastasis has not been clearly deline- ated. However, over the past few years, morbidity and mortality improvements after surgical resection of the pancreas have enabled patients with metastatic disease to be treated with radical intent [4,5]. Here, we report our ex- periences of eleven patients who underwent pancreatic re- section for metastasis to the pancreas. Correspondence to: Dong Wook Choi Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea Tel: ＋82-2-3410-3460, Fax: ＋82-2-3410-6980, E-mail: dw7722.choi@samsung.com cc Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2011, the Korean Surgical Society