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부선진 ( Sun Jin Boo ),김명환 ( Myung Hwan Kim ),김유석 ( Yu Seok Kim ),류충헌 ( Choong Heon Ryu ),김홍준 ( Hong Jun Kim ),박도현 ( Do Hyun Park ),이상수 ( Sang Soo Lee ),서동완 ( Dong Wan Seo ),이성구 ( Sung Koo Lee ),김송철 ( So 대한소화기학회 2011 대한소화기학회지 Vol.57 No.6
Background/Aims: Histologically confirmed metastatic pancreatic cancers are infrequent. The aim of this study was to analyze clinical, therapeutic and prognostic features of pancreatic metastases. Methods: We retrospectively evaluated stage of primary malignancies, interval between diagnosis of primary tumors and detection of pancreatic metastases, treatment for metastases to the pancreas, survival rate, and prognostic factors in 31 patients with pancreatic metastases. Results: The mean age at the time of primary cancer diagnosis was 52.4±13.2 years. Primary cancers were renal cell carcinoma (n=16), non-small cell lung cancer (n=6), small cell lung cancer (n=3), colorectal carcinoma (n=2), osteosarcoma (n=1), gastric carcinoma (n=1), malignant melanoma (n=1), and thymic carcinoma (n=1). Pancreatic metastases were synchronous in six cases and metachronous in twenty five cases, with median interval time of 40.8 months (range 3-186) between the diagnosis of primary tumor and detection of pancreatic metastases. The median survival after the detection of the metastases was 16 months. In multivariate analysis, non-renal cell carcinoma as primary malignancy and positive symptom related to pancreatic metastases were associated with poor prognosis (hazard ratio [HR], 8.33; 95% CI, 2.1-33; p=0.003, and HR, 4.02; 95% CI, 1.27-12.7; p=0.018). Conclusions: Metastatic tumors to the pancreas have to be kept in mind when a patient with pancreatic mass has a history of other malignancy, even if treated several years before. In the absence of widely metastatic disease, aggressive diagnostic and therapeutic approach may offer the chance of long-term survival in selected patients. (Korean J Gastroenterol 2011;57:358-364)