Brain Metastasis in Pancreatic Cancer

Abstract

Pancreatic cancer is a fatal disease with a 5-year survival rate below 5%. Most patients are diagnosed at an advanced tumor stage and existence of distant metastases. However, involvement of the central nervous system is rare in pancreatic cancer. We retrospectively analyzed all cases of brain metastases in pancreatic cancer reported to date focusing on patient characteristics, clinical appearance, therapy and survival. Including our own, 12 cases of brain metastases originating from pancreatic cancer were identified. In three patients brain metastases were the first manifestation of pancreatic cancer. All other patients developed brain metastases during their clinical course. In most cases, the disease progressed rapidly and the patients died within weeks or months. However, two patients showed long-term survival. Of note, both patients received resection of the pancreatic cancer as well as curative resection of the metachronous brain metastases. Brain metastases in pancreatic cancer are a rare condition and usually predict a very poor prognosis. However, there is evidence that resection of brain metastases of pancreatic cancer can be immensely beneficial to patient’s survival, even with the chance for cure. Therefore, a surgical approach in metastatic pancreatic cancer should be considered in selective cases.

Brain metastasis from pancreatic cancer: A case report and literature review

“…[ 13 14 ] Although several cases of PC with brain metastases have been reported, the majority of such cases have been identified postmortem. [ 6 7 8 15 16 ] To the best of our knowledge, only 20 cases in which brain metastases from PC were identified ante-mortem have been reported until date, including the present case. [ 8 9 10 11 12 14 17 18 19 20 21 22 23 24 ] Table 1 summarizes the clinical features.…”

Brain Metastases in Gastrointestinal Cancers: Is there a Role for Surgery?

“…None of them was eligible (and/or considered) for surgical treatment and their clinical course was fatal with a median survival of 2.9 months. In addition to this study, only a small number of case reports described this unusual site of pancreatic cancer metastases [ 44 ]. Due to the very small number of reported cases, the value of any treatment strategy for brain metastases arising from pancreatic cancer remains unsolved.…”

Development and Validation of a Nomogram to Predict Liver Metastasis in Patients with Pancreatic Ductal Adenocarcinoma: A Large Cohort Study

“…Distant metastasis is a common sign of advanced stages and indicates poor prognosis for patients with PDAC. Liver metastasis is the most common site of metastases, 15,16 which also indicates worse outcomes than patients with other sites of distant metastases. 7 At present, the standard treatment for metastatic PDAC is chemotherapy, which can only provide limited benefit to increase the patient's survival.…”