Clinicopathological Features of Delayed Isolated Lung Metastases after Radical Pancreatectomy for Pancreatic Cancer

Kabuto Takano, Isao Kurosaki, Masahiro Minagawa, Chie Kitami, Kazutoshi Date* and Katsuyoshi Hatakeyama

Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
Department of Surgery, Niigata Rosai Hospital*

Clinical characteristics and the treatment of the lung metastases from pancreatic cancer have not been fully investigated. We report clinical features of 4 cases with isolated lung metastases that had been proven by immunohistochemical method and examined the efficacy of chemotherapy. Four cases received gemcitabine chemotherapy after primary pancreatectomy. Thoracic high resolution CT detected lung nodules in all cases. Disease free survival was 26-78 months. All cases received resection of lung nodule; 2 cases with single nodule were diagnosed as primary lung cancer and another 2 cases with two nodules were diagnosed as lung metastases. In all cases, pathological and immunohistochemical examination revealed lung metastasis from pancreatic cancer. All but one patient received combination with gemcitabine and TS-1 chemotherapy after lung resection. Two cases died of relapse at 32, 14 months after lung resection, while another 2 cases are alive at 36, 14 months. Isolated lung metastasis after radical surgery for pancreatic cancer showed delayed recurrence and low malignant potential. Long survival term was obtained by chemotherapy after lung resection. It is suggested that close follow-up after pancreatectomy and effective chemotherapy seem to be essential for improving the prognosis of the lung recurrence.

Key words
pancreatic cancer, isolated lung metastases, chemotherapy

Reprint requests
Kabuto Takano Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 JAPAN

Accepted
May 19, 2010

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