Pulmonary Adenocarcinoma Occurring 5 Years after Resection of a Primary Pancreatic Adenocarcinoma: A Relevant Differential Diagnosis

Falkenstern-Ge, R. F.; Wohlleber, M; Kimmich, Martin; Huettl, Katrin; Friedel, Godehard; Ott, German; Kohlhäufl, Martin

doi:10.1155/2014/841907

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Thus, the post relapse survival after surgery for isolated pulmonary metastases has to be considered with certain precautions. However, it is a well-established observation that a superior DFS is mostly found in patients with pulmonary metastases (19,(31)(32)(33). This is in-line with a recent SEER analysis from Liu et al, who demonstrated that resection in highly selected patients with either isolated synchronous or metachronous pulmonary metastases is correlated with a signi cant survival bene t in PDAC (34).…”

Section: Discussionsupporting

confidence: 70%

Site of Relapse of Ductal Adenocarcinoma of the Pancreas Affects Survival after Multimodal Therapy

Safi¹,

Lehwald²,

Rehders³

et al. 2020

Preprint

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Background: Ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unknown, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and post relapse survival (PRS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases.Methods: Patients with isolated resectable local recurrence, metachronous hepatic or pulmonary metastases were included for survival analyses. PRS of surgically treated patients (local (n=11), hepatic (n=6) and pulmonary metastases (n=9)) was compared to conservatively treated patients (local (n=17), hepatic (n=37) and pulmonary metastases (n=8)).Results: Resected PDAC patients suffering from isolated metachronous hepatic metastases initially had a higher T-stage and venous invasion (V1) compared to the other patients. DFS in the metachronous pulmonary metastases group was longer compared to DFS of the hepatic metastases and local recurrence groups. Surgical resection significantly improved PRS in patients with local recurrence and pulmonary metastases, when compared to patients receiving chemotherapy alone. Very-long term survivors (>5 years) were detected following secondary resection of local recurrence and 45% of these patients were still alive at the end of our study period.Conclusion: Although DFS in PDAC patients suffering from isolated local recurrence was dismal and comparable to that of patients with isolated hepatic metastases, very-long term survivors were present only in this group. These results indicate that a surgical approach for isolated local recurrence, if anatomically possible, should be considered.

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Section: Discussionsupporting

confidence: 70%

Site of Relapse of Ductal Adenocarcinoma of the Pancreas Affects Survival after Multimodal Therapy

Safi¹,

Lehwald²,

Rehders³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Thus, the relapse speci c survival after surgery for isolated pulmonary metastases has to be considered with certain precautions. However, it is a well established observation that a superior survival until relapse diagnosis is mostly found in patients with pulmonary metastases [19,[31][32][33]. This is in-line with a recent SEER analysis from Liu et al who demonstrated that resection in highly selected patients with either isolated synchronous or metachronous pulmonary metastases is correlated with a signi cant survival bene t [34].…”

Section: Discussionsupporting

confidence: 61%

Site of Relapse of the Ductal Adenocarcinoma of the Pancreas affects Survival after Multimodal Therapy

Safi

Lehwald

Rehders

et al. 2020

Preprint

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Background The ductal adenocarcinoma of the pancreas (PDAC) remains one of the most lethal malignancies. To date, no guidelines exists for isolated resectable metachronous disease. It is still unclear, which patients may benefit from relapse surgery. The aim of our study was to compare disease free survival (DFS) and relapse specific survival (RSS) in patients with isolated local recurrence, metachronous hepatic or pulmonary metastases. Methods Patients with isolated resectable metachronous disease of either local recurrence, hepatic or pulmonary metastases were included for survival analyses. RSS of surgically treated patients (local (n = 11), hepatic (n = 6) and pulmonary metastases (n = 11)) were compared to conservative treated patients (local (n = 20), hepatic (n = 49) and pulmonary metastases (n = 14)). Results Patients with isolated metachronous hepatic metastases showed a higher T-stage and hepatic M-stage in the primary staging of the previous resected PDAC when compared to the other patients. DFS before diagnosed pulmonary metastases was longer compared to DFS before diagnosed hepatic metastases or local recurrence. Surgical resection only significantly improved RSS in patients with local recurrence or pulmonary metastases, when compared to patients after chemotherapy. Long-term survivors (> 5 years) were only detected after surgery for isolated local recurrence and 45% of these patients were still alive in our study. Conclusion Although DFS before diagnosed isolated local recurrence was dismal and comparable to patients with isolated hepatic metastases, long-term survivors were only detected in this group, recommending a surgical approach if resectability is provided.

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“…A metachronous tumor is defined as the development of two primary malignant lesions usually with lag time, often years, between the first and second lesion [ 3 ]. Although rare, there have been many reports of metachronous pancreatic and lung adenocarcinoma [ 4 – 6 ]. Metachronous malignant lesions pose diagnostic dilemma since they are hard to differentiate from other metastatic lesions [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although rare, there have been many reports of metachronous pancreatic and lung adenocarcinoma [ 4 – 6 ]. Metachronous malignant lesions pose diagnostic dilemma since they are hard to differentiate from other metastatic lesions [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Solitary Skull Metastasis as the First Presentation of a Metachronous Primary Lung Cancer in a Survivor from Pancreatic Cancer

Altalhy

Maghrabi

Al-Mansouri

et al. 2017

Case Reports in Oncological Medicine

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Skull metastasis from lung cancer is relatively common, yet the first presentation for this malignant disease is a rare occurrence. We herein report a case of a 54-year-old female, who had a good outcome following Whipple procedure for periampullary adenocarcinoma five years before her current presentation. During a routine follow-up, she was found to have a slowly progressive painless right parietal swelling. The systemic screening workup revealed no abdominal disease, but a solitary pulmonary nodule was identified. The presence of these two lesions raised the diagnosis of metastases from a previously treated pancreatic adenocarcinoma. The patient underwent complete excision of the skull lesion and subsequent lung biopsy, both of which proved on histopathological examination to be consistent with a primary lung cancer. This case emphasizes the importance of imaging and histopathological correlation in the diagnosis of solitary skull metastases and their effect on the subsequent management.

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Pulmonary Adenocarcinoma Occurring 5 Years after Resection of a Primary Pancreatic Adenocarcinoma: A Relevant Differential Diagnosis

Cited by 5 publications

References 8 publications

Site of Relapse of Ductal Adenocarcinoma of the Pancreas Affects Survival after Multimodal Therapy

Site of Relapse of Ductal Adenocarcinoma of the Pancreas Affects Survival after Multimodal Therapy

Site of Relapse of the Ductal Adenocarcinoma of the Pancreas affects Survival after Multimodal Therapy

Solitary Skull Metastasis as the First Presentation of a Metachronous Primary Lung Cancer in a Survivor from Pancreatic Cancer

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