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

• Authors: Orimisan Samuel Adekolujo, Michigan State University; Ahsan Wahab, Prattville Baptist Hospital; Maxwell Oluwole Akanbi, Michigan State University; Tolutope Oyasiji, Wayne State University; Borys Hrinczenko, Michigan State University; Olatunji Boladale Alese, Emory University
• Journal Title: CANCER BIOLOGY & THERAPY
• Volume: Volume 24, Number 1
• Publisher: TAYLOR & FRANCIS INC | 2023-12-31, Pages 2198479-2198479
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1080/15384047.2023.2198479
• Subjects: Health Sciences, Oncology; Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; Pancreatic ductal adenocarcinoma; isolated pulmonary metastases; pulmonary metastasectomy; Lung resection; survival; COLORECTAL-CANCER; CURATIVE RESECTION; PRIMARY RECURRENCE; IMPROVED SURVIVAL; PROGNOSTIC-FACTOR; LIQUID BIOPSY; RISK-FACTORS; SURGERY; LUNG; EXPRESSION

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.