Isolated pulmonary metastases in pancreatic ductal adenocarcinoma: a review of current evidence

Abstract

Despite recent advances in cancer therapeutics, pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease with a 5-year overall survival of only 10%. Since either at or within a few months of diagnosis, most patients with PDAC will present with metastatic disease, a more individualized approach to select patients who may benefit from more aggressive therapy has been suggested. Although studies have reported improved survival in PDAC and isolated pulmonary metastasis (ISP) compared to extrapulmonary metastases, such findings remain controversial. Furthermore, the added benefit of pulmonary metastasectomy and other lung-directed therapies remains unclear. In this review, we discuss the metastatic pattern of PDAC, evaluate the available evidence in the literature for improved survival in PDAC and ISP, evaluate the evidence for the added benefit of pulmonary metastasectomy and other lung-directed therapies, identify prognostic factors for survival, discuss the biological basis for the reported improved survival and identify areas for further research.

Temoporfin-Conjugated PEGylated Poly(N,N-dimethylacrylamide)-Coated Upconversion Colloid for NIR-Induced Photodynamic Therapy of Pancreatic Cancer

“…3 While surgery remains the first choice of treatment for this disease, resection is considered to be effective for less than 20% of patients at initial diagnosis and is not an option for more than 80% of patients with locally advanced or metastatic disease. 4 In patients with inoperable pancreatic cancer, aggressive chemotherapy with the pyrimidine nucleoside analogues capecitabine and 5-fluorouracil is the primary treatment, but its clinical efficacy is still unsatisfactory. 5 As a result, the median overall survival of patients with metastatic disease is less than one year.…”