Is There a Potential Oncologic Role for Local Therapy on Hepatic Metastasis in Patients Who Undergo Curative Pancreatectomy for Pancreatic Cancer?

• Published in: Yonsei medical journal Vol. 66; no. 6; pp. 329 - 336
• Main Authors: Kim, Jun Hyung, Hong, Seung Soo, Kim, Sung Hyun, Hwang, Ho Kyung, Kang, Chang Moo
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.06.2025; 연세대학교의과대학
• Subjects: Adult; Aged; Female; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver Neoplasms - therapy; Male; Middle Aged; Original; Pancreatectomy - methods; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Retrospective Studies; 의학일반; Hepatic metastasis; radiofrequency ablation; pancreatic neoplasms; pancreatectomy
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2024.0078

In pancreatic cancer, therapeutic investigations targeting liver metastases could improve survival. However, the use of local treatment for oligometastasis in pancreatic cancer remains controversial. This study aimed to investigate the oncological role of local therapy in patients who underwent curative pancreatectomy and subsequently developed liver metastases. Data concerning patients who underwent curative pancreatectomy for pancreatic cancer at Severance Hospital in Seoul, South Korea between 2006 and 2018 were retrospectively reviewed. We included patients with one or two liver metastases, as confirmed on imaging. We excluded those with metastases in other organs. The patients were divided into two groups: the NT group, receiving conventional therapy without local treatment; and the LT group, receiving local treatments for liver metastases alongside standard therapy. Of the 43 included patients (NT group, n=33; LT group, n=10), no significant differences were observed in overall survival (OS) [hazard ratio (HR) 0.846; 95% confidence interval (CI) 0.397-1.804; =0.665] or post-recurrence survival (HR 0.932; 95% CI 0.437-1.985, =0.855) between the two groups. In multivariate analysis, early recurrence within 6 months ( <0.001) and the use of 5-fluorouracil (FU)-based adjuvant chemotherapy (CTx) ( =0.011), as well as 5-FU-based CTx after liver metastasis ( =0.008) when compared with gemcitabine-based regimens, were significant predictors of poor OS. The oncologic role of local treatment for hepatic metastasis remains controversial in patients with hepatic metastasis after radical pancreatectomy. In the era of potent chemotherapeutic regimens, further research is needed to clarify the efficacy of such regimens.