Abstract
Background
This study aimed to evaluate the results of synchronous liver resection for metastatic
pancreatic ductal adenocarcinomas and to identify prognostic factors for overall survival.
Methods
We retrospectively reviewed clinical data from patients who underwent the synchronous
resection of pancreatic adenocarcinoma with liver metastases. Cox analyses were used
to identify factors prognostic of overall survival.
Results
Of the 92 patients included in this study, preoperative chemotherapy was administered
to 52 patients. The median overall survival was 18.26 months (95% confidence interval:
14.7–22.7) (from diagnosis) and 12.68 months (95% confidence interval: 9.5–15.57)
from surgery; overall survival at 1, 3, and 5 years was 70%, 10%, and 0%, respectively.
Twenty-eight patients (30.4%) had median overall survival >18 months after surgery.
The median overall survival from diagnosis was longer in patients undergoing preoperative
treatment (22.7 vs 13.8 months; P = .01) but similar after surgery (12.6 vs 13.8 months; P = .86). Multivariate Cox analysis found CA19-9 levels <500 kU/L (hazard ratio: 0.35;
95% confidence interval: 0.17–0.70; P = .003), R0 resection (hazard ratio: 0.46; 95% confidence interval: 0.24–0.88; P = .020), and adjuvant chemotherapy (hazard ratio: 0.39; 95% confidence interval:
0.17–0.88; P = .024) as independent prognostic factors for overall survival.
Conclusion
Survival after resection of oligometastatic liver disease remains limited, reflecting
the dismal prognosis of metastatic disease even after aggressive treatment. Preresection
CA19-9 serum levels represent a useful tool for patient selection, and administration
of adjuvant chemotherapy has a major impact on overall survival. Large comparative
studies with exclusive chemotherapy are needed to validate this approach and to identify
optimal candidates.
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Article info
Publication history
Published online: April 11, 2022
Accepted:
March 2,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
