Aims of the study To evaluate the diagnosis, treatment and outcome of patients with pancreatic metastases. Patients and methods We retrospectively reviewed the records of patients with pancreatic metastasis managed in...Aims of the study To evaluate the diagnosis, treatment and outcome of patients with pancreatic metastases. Patients and methods We retrospectively reviewed the records of patients with pancreatic metastasis managed in the Paris area between 1990 and 2000. Results The series analyzed included 22 patients, 10 men and 12 women, mean age 61 years (range: 35-76). The primary tumors were renal cell carcinoma (N = 10), colorectal cancer (N = 4), lung cancer (N = 4), breast cancer (N = 2), cutaneous melanoma (N = 1) and ileal carcinoid (N = 1). The mean interval between primary treatment and presentation was 73.5 months (range: 2-151). Diagnosis was established because of clinical symptoms (N = 15) or during surveillance (N = 7). Computed tomography (N = 19) and endoscopie ultrasound (EUS) (N= 18) mainly showed solitary and hypodense/or hypoechoic masses. Histological diagnosis was obtained before surgery by EUS guided fine needle aspiration(N =6), ultra sound guided biopsy (N = 3) or duodenoscopy (N = 3). Among 10 patients with primary renal cell carcinoma, 7 were treated by surgery. Median global survival was 33 months. Median survival was 61 months in the event of surgical treatment and 20 months in the other patients (ns). Mean survival depended on the type of primary tumor, 61 months for renal cell carcinoma and 33 for colorectal cancer (P = 0.06). Conclusions Most pancreatic metastases develop from renal cell carcinoma and can occur several years after nephrectomy. Histological diagnosis is often obtained before surgery. Surgical resection must be discussed as it can allow long term survival.展开更多
Background-The efficacy and benefit of second-line chemotherapy in advanced pancreatic adenocarcinoma has never been demonstrated although it is regularly used.Patients and methods-A randomized phase II study evaluati...Background-The efficacy and benefit of second-line chemotherapy in advanced pancreatic adenocarcinoma has never been demonstrated although it is regularly used.Patients and methods-A randomized phase II study evaluating oxaliplatin alone(OXA) ,infusional 5-fluorouracil alone(5-FU) and an oxaliplatin/infusional 5-FU combination(OXFU) in untreated advanced pancreatic adenocarcinoma has been conducted.In this trial,a second-line treatment with the OXFU regimen(OXA 130 mg/m2 2-h intravenous(i.v.) infusion combined with 5-FU(1000 mg/m2/day,continuous i.v.,days 1-4) ,every 3 weeks) was offered to patients progressing after single agent treatment.Results-Eighteen out of 32 patients(12 males,median age 57 years) treated in the single agent arms received the OXFU combination in second-line treatment.WHO performance status was at least 2 in 61% of the patients.There was no objective response and 3 patients(17%) had a disease stabilisation.Median time to progression from the start of second-line treatment was 0.9 months.Median overall survival was 4.9 months from the start of front-line therapy and 1.3 months from the start of second-line therapy.Conclusion-The results of this trial bring arguments to support a modest value of second-line chemotherapy for advanced pancreatic adenocarcinoma.展开更多
文摘Aims of the study To evaluate the diagnosis, treatment and outcome of patients with pancreatic metastases. Patients and methods We retrospectively reviewed the records of patients with pancreatic metastasis managed in the Paris area between 1990 and 2000. Results The series analyzed included 22 patients, 10 men and 12 women, mean age 61 years (range: 35-76). The primary tumors were renal cell carcinoma (N = 10), colorectal cancer (N = 4), lung cancer (N = 4), breast cancer (N = 2), cutaneous melanoma (N = 1) and ileal carcinoid (N = 1). The mean interval between primary treatment and presentation was 73.5 months (range: 2-151). Diagnosis was established because of clinical symptoms (N = 15) or during surveillance (N = 7). Computed tomography (N = 19) and endoscopie ultrasound (EUS) (N= 18) mainly showed solitary and hypodense/or hypoechoic masses. Histological diagnosis was obtained before surgery by EUS guided fine needle aspiration(N =6), ultra sound guided biopsy (N = 3) or duodenoscopy (N = 3). Among 10 patients with primary renal cell carcinoma, 7 were treated by surgery. Median global survival was 33 months. Median survival was 61 months in the event of surgical treatment and 20 months in the other patients (ns). Mean survival depended on the type of primary tumor, 61 months for renal cell carcinoma and 33 for colorectal cancer (P = 0.06). Conclusions Most pancreatic metastases develop from renal cell carcinoma and can occur several years after nephrectomy. Histological diagnosis is often obtained before surgery. Surgical resection must be discussed as it can allow long term survival.
文摘Background-The efficacy and benefit of second-line chemotherapy in advanced pancreatic adenocarcinoma has never been demonstrated although it is regularly used.Patients and methods-A randomized phase II study evaluating oxaliplatin alone(OXA) ,infusional 5-fluorouracil alone(5-FU) and an oxaliplatin/infusional 5-FU combination(OXFU) in untreated advanced pancreatic adenocarcinoma has been conducted.In this trial,a second-line treatment with the OXFU regimen(OXA 130 mg/m2 2-h intravenous(i.v.) infusion combined with 5-FU(1000 mg/m2/day,continuous i.v.,days 1-4) ,every 3 weeks) was offered to patients progressing after single agent treatment.Results-Eighteen out of 32 patients(12 males,median age 57 years) treated in the single agent arms received the OXFU combination in second-line treatment.WHO performance status was at least 2 in 61% of the patients.There was no objective response and 3 patients(17%) had a disease stabilisation.Median time to progression from the start of second-line treatment was 0.9 months.Median overall survival was 4.9 months from the start of front-line therapy and 1.3 months from the start of second-line therapy.Conclusion-The results of this trial bring arguments to support a modest value of second-line chemotherapy for advanced pancreatic adenocarcinoma.
