Background: Several case series reported results of surgical resection in patients with pancreatic ductal adenocarcinoma in a metastasized stage.
Aim: A summarized overview of the current state of knowledge and a summary of the results of currently available studies.
Material and methods: A systematic search was carried out in MEDLINE and PubMed with respect to metastasized pancreatic cancer and surgical resection.
Results: The evidence level for surgical resection in the metastasized stage is weak and so far no prospective trials are available. The largest single-arm trial included 85 patients with hepatic metastasis. In cases of hepatic oligometastasis an overall survival of 11-14 months was observed. In the presence of pulmonary metastasis, overall survival seems to be prolonged compared to intra-abdominal metastasis, although the evidence level is relatively weak.
Conclusion: According to the available results, a general recommendation for surgical resection in a metastasized stage cannot be given; however, the results show a possible benefit for some well-selected patient subgroups. Prospective trials must validate these data and investigate the use of combined surgical and systemic treatments in the case of resectable metastatic pancreatic cancer.
Keywords: Ablative procedures; Hepatic metastasis; Multimodal therapy; Pulmonary metastases; Resection.