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Simultaneous resection of abdominal cancer and synchronous pancreaticoduodenal metastasis: Indications and literature review
Author(s) -
Tan Jing Wang,
Wang Hong Dong,
Hu Ben Shun,
Chen Ke,
Xu Hong Bin,
Chen Fei,
Tan Yun Chang,
Dong Jia Hong
Publication year - 2012
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2012.00628.x
Subject(s) - medicine , paraaortic lymph nodes , metastasis , duodenum , lymph , surgery , cancer , pancreaticoduodenectomy , pancreas , radiology , oncology , pathology
Objective This study was aimed to identify the potential indications for simultaneous resection of abdominal cancer and synchronous pancreaticoduodenal metastasis ( SRAPM ) and improve the efficacy of SRAPM . Methods The data of 34 patients who underwent SRAPM were retrospectively reviewed. The intraoperative findings, morbidity and mortality, patterns of tumor invasion in the pancreas and duodenum, lymph node metastases, long‐term outcomes and causes of death were evaluated. Results Fourteen patients (41.2%) developed complications, and 2 died of pancreatic fistulas with abdominal bleeding. The in‐hospital mortality was 5.9%. The overall 1‐year, 2‐year and 3‐year survival rates were 52.9%, 32.3% and 21.8%, respectively. The survival rates depended on the primary tumor, the invasion pattern, the presence of metastatic lymph nodes at the paraaortic site and the presence of residual tumor. The follow‐up outcomes revealed that the main causes of death were as follows: systemic metastasis ( n = 7), peritoneal metastasis ( n = 6) and intrahepatic metastasis ( n = 6). Conclusions SRAPM is indicated for low‐grade malignant tumors and in cases with direct invasion of the pancreaticoduodenum. The presence of metastatic lymph nodes at the paraaortic site, intrahepatic metastasis, micro‐peritoneal metastasis, and distinct metastasis should be contraindications for the surgical procedure.