Pancreatic resection in patients with synchronous extra-pancreatic malignancy: outcomes and complications

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Mehta, Shreya
Tan, Grace I
Nahm, Christopher B
Chua, Terence C
Pearson, Andrew
Gill, Anthony J
Samra, Jaswinder S
Mittal, Anubhav
Griffith University Author(s)
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2020
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Abstract

Background: Patients may present with a resectable pancreatic tumour in the context of a concurrent primary extra-pancreatic malignancy. These patients pose a dilemma regarding their suitability for surgery. We evaluated our experience with such patients who underwent pancreatic resection with curative intent and detailed their outcomes and rationale for surgical decision-making. Methods: A retrospective review of patients with pancreatic concurrent extra-pancreatic primary malignancy who underwent pancreatic resection at our institution over a 12-year period (2005–2016) was performed. Clinical, histopathological and perioperative outcomes were reviewed. Results: Ten patients with a median age of 74 years (40–85 years) were identified. Secondary primary tumours included thyroid (n = 2), gastrointestinal (n = 4), small bowel neuroendocrine (n = 1), renal (n = 1) and haematological malignancies (n = 2). Pancreatic tumours included pancreatic ductal adenocarcinomas (n = 6), solid pseudopapillary neoplasms (n = 2) and ampullary carcinomas (n = 2). After a median follow up of 41.3 months (31.3–164 months), 8 of 10 patients were still alive. Two patients died due to metastatic disease from the secondary malignancy (small bowel neuroendocrine tumour and sigmoid colon adenocarcinoma). The post-operative complication rate was 30% with no perioperative 90-day mortality. Conclusion: Selected patients with a pancreatic and concurrent primary extra-pancreatic malignancy may undergo curative pancreatic resection with favourable outcomes.

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ANZ Journal of Surgery

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90

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3

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Clinical sciences

Science & Technology

Life Sciences & Biomedicine

Surgery

cancer

malignancy

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Mehta, S; Tan, GI; Nahm, CB; Chua, TC; Pearson, A; Gill, AJ; Samra, JS; Mittal, A, Pancreatic resection in patients with synchronous extra-pancreatic malignancy: outcomes and complications, ANZ Journal of Surgery, 2020, 90 (3), pp. 290-294

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