Reply to 'Is Liver Resection in Metastases of Exocrine Pancreatic Carcinoma Justified

JOP. J Pancreas (Online) 2011 Jan 5; 12(1):71.

Reply to ‘Is Liver Resection in Metastases of Exocrine Pancreatic Carcinoma Justified?’

Amanjeet Singh, Tanveer Singh, Adarsh Chaudhary

Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, Rajinder Nagar. New Delhi, India

Dear Sir,

We thank Dr. Saif for showing interest in our article [1]. Our aim was only to present our limited experience with synchronous resections in a selected group of patients. We agree with Dr. Saif that this should be performed in a high volume center and only a small number of patients are candidates for these procedures. We used gemcitabine-based adjuvant therapy in patients who received this procedure: all the patients in the synchronous selected group and 134 (60.1%) of the other 223 patients.

In this study, three patients with pancreatic head cancer underwent synchronous resection of a liver metastasis along with the primary tumors. On follow-up, two developed local recurrences and only one had systemic disease in the form of liver metastases. This indicates the probable locally aggressive nature of the disease rather than a distant metastasis.

There is some evidence available for the use of neoadjuvant treatment for locally unresectable tumors detected on preoperative imaging [2], but its role in resectable pancreatic cancers [3] and in patients with metastatic disease in an otherwise resectable cancer needs to be investigated in future studies.

Received November 27^th, 2010

Keywords Chemotherapy, Adjuvant; Neoplasm Metastasis; Pancreatic Neoplasms

Conflict of interest The authors have no potential conflict of interest

Correspondence
Adarsh Chaudhary
Department of Surgical Gastroenterology
Sir Ganga Ram Hospital
Room No 2208A
Rajinder Nagar
New Delhi
India 110060
Phone: +91-11.225.2226, +91-981.030.1847
Fax: +91-11.4225.2224
E-mail: adarsh_chaudhary@yahoo.com

References

1. Saif MW. Is liver resection in metastases of exocrine pancreatic carcinoma justified? JOP. J Pancreas (Online) 2011; 12:68-9.

2. Kleeff J, Friess H, Buchler MW. Neoadjuvant therapy for pancreatic cancer. Br J Surg 2007; 94:261-2. [PMID 17315287]

3. Reni M. Neoadjuvant treatment for resectable pancreatic cancer: time for phase III testing? World J Gastroenterol 2010; 16:4883-7. [PMID 20954273]