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Oligometastasierung beim Pankreaskarzinom

Aktueller Kenntnisstand und Spektrum der Lokaltherapie

Oligometastasis in pancreatic cancer

Current state of knowledge and spectrum of local therapy

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Zusammenfassung

Hintergrund

Mehrere Fallserien berichten von Ergebnissen nach resezierenden Eingriffen im metastasierten Stadium beim duktalen Adenokarzinom des Pankreas.

Fragestellung

Der Beitrag fasst den aktuellen Kenntnisstand und die Ergebnisse bislang veröffentlichter Studien zusammen.

Material und Methoden

Systematische MEDLINE- und PUBMED-Recherche zum Thema resezierende Eingriffe am Pankreas im metastasierten Stadium.

Ergebnisse

Das Evidenzniveau ist schwach, es gibt aktuell keine prospektiven Analysen zu diesem Thema. Die größte Studie schloss 85 Patienten mit hepatischen Metastasen ein. Beim Vorliegen weniger hepatischer Metastasen konnten nach der Resektion Überlebenszeiten von 11 bis 14 Monaten erreicht werden. Das Überleben beim Vorliegen pulmonaler Metastasen scheint im Vergleich zu intraabdominellen Metastasen deutlich verlängert zu sein.

Schlussfolgerung

Die Ergebnisse der vorliegenden Studie erlauben keine generelle Aussage darüber, ob resezierende Eingriffe im metastasierten Stadium gerechtfertigt sind. Dennoch zeigen die Ergebnisse einen möglichen Vorteil für gewisse Patientensubpopulationen. Prospektive Studien sind zwingend notwendig, um einen möglichen Stellenwert chirurgischer Eingriffe im metastasierten Stadium belegen zu können.

Abstract

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.

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Authors and Affiliations

  1. Klinik für Allgemein‑, Viszeral und Tumorchirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland

    F. Gebauer, A. I. Damanakis & C. Bruns

Authors
  1. F. Gebauer
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  2. A. I. Damanakis
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  3. C. Bruns
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Corresponding author

Correspondence to F. Gebauer.

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Interessenkonflikt

F. Gebauer, A. I. Damanakis und C. Bruns geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Gebauer, F., Damanakis, A.I. & Bruns, C. Oligometastasierung beim Pankreaskarzinom. Chirurg 89, 510–515 (2018). https://doi.org/10.1007/s00104-018-0626-1

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