Liver resection for synchronous metastasis from adenocarcinoma of the pancreas: international multicenter cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction: Treatment aiming to cure pancreatic ductal adenocarcinoma (PDAC) is primarily based on radical surgical resection. However, in most patients, distant metastases are already detectable at the time of diagnosis, preventing a curative treatment pathway. Methods: Cases of PDAC with synchronous liver metastasis were collected from 14 international centers across multiple countries and continents. The study was promoted by the International Society of Liver Surgeons (ISLS) to define the role of simultaneous pancreatic and liver surgery in the treatment of oligometastatic PDAC. Overall survival (OS) and the cumulative incidence function of recurrence were estimated in a surgical cohort, and OS was compared with that of a non-surgical control group. Results: Fifty patients were included in the surgical cohort. Most of the procedures were Whipples (60%), associated with wedge resections of the liver (86%). The median hospital stay was 10 days, with a median Comprehensive Complication Index (CCI) of 12, and 68% of the patients spent no more than 1 day in the intensive care unit (ICU). In the surgical group, OS at 6, 12, and 24 months after surgery was 83%, 69%, and 49%, respectively. The adjusted hazard ratio (HR) (surgical vs non-surgical cohort) was 0.26 (95% CI: 0.12–0.55, P < 0.001). Conclusions: The results of this international multicenter study further support the hypothesis that oligometastatic PDAC represents an intermediate stage between localized and overtly metastatic cancer. Therefore, following primary chemotherapy and in carefully selected patients based on the A–B–C paradigm, resection of the primary pancreatic tumor along with liver metastases may be considered.
Source: International Journal of Surgery
Authors: Paolo Magistri, Cristiano Guidetti, Andrea Spallanzani, Kubra Vardar, Samuele Frassoni, Vincenzo Bagnardi, Andrea Belli, Reinhold Klug, Nikolaos Machairas, Kvasivka Oleksandr, Alejandro Serrablo, Alpen Yahya Gümüşoğlu, Marco Vivarelli, Riccardo Memeo, Erdinc Kamer, Fabrizio Romano, Ricky Harminder Bhogal, Ugo Boggi, Luciano De Carlis, Nurhilal Kiziltoprak, Stefano Di Sandro, Massimo Dominici, Deniz Balci, Orlando Jorge Torres, Fabrizio Di Benedetto
Institutions: University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Istanbul Kent University, University of Milano-Bicocca, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Laiko General Hospital of Athens, National Cancer Institute, Hospital Universitario Miguel Servet, Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi, Marche Polytechnic University, LUM Jean Monnet University, Ospedale Generale Regionale Francesco Miulli, Sağlık Bilimleri Üniversitesi, Institute of Cancer Research, Royal Marsden Hospital, University of Pisa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Bahçeşehir University, Universidade Federal do Maranhão
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,450
OpenAlex ID: W7161944481