Isolated pulmonary metastases in pancreatic ductal adenocarcinoma: a review of current evidence

Cancer Biol Ther. 2023 Dec 31;24(1):2198479. doi: 10.1080/15384047.2023.2198479.

Abstract

Despite recent advances in cancer therapeutics, pancreatic ductal adenocarcinoma (PDAC) remains a lethal disease with a 5-year overall survival of only 10%. Since either at or within a few months of diagnosis, most patients with PDAC will present with metastatic disease, a more individualized approach to select patients who may benefit from more aggressive therapy has been suggested. Although studies have reported improved survival in PDAC and isolated pulmonary metastasis (ISP) compared to extrapulmonary metastases, such findings remain controversial. Furthermore, the added benefit of pulmonary metastasectomy and other lung-directed therapies remains unclear. In this review, we discuss the metastatic pattern of PDAC, evaluate the available evidence in the literature for improved survival in PDAC and ISP, evaluate the evidence for the added benefit of pulmonary metastasectomy and other lung-directed therapies, identify prognostic factors for survival, discuss the biological basis for the reported improved survival and identify areas for further research.

Keywords: Lung resection; Pancreatic ductal adenocarcinoma; isolated pulmonary metastases; pulmonary metastasectomy; survival.

Publication types

  • Review

MeSH terms

  • Carcinoma, Pancreatic Ductal* / pathology
  • Humans
  • Lung Neoplasms*
  • Pancreatic Neoplasms* / pathology
  • Prognosis
  • Retrospective Studies

Grants and funding

The author(s) reported there is no funding associated with the work featured in this article.