• World Neurosurg · Oct 2022

    Brain Metastasis from Pancreatic Cancer: Our Experience and Systematic Review.

    • Frank A De Stefano, Alexis Morell, Katya Marks, Sophia Fernandez, Grace Smith, Timothy Mayo, Martin Merenzon, Ashish H Shah, Daniel G Eichberg, Evan Luther, Michael E Ivan, and Ricardo J Komotar.
    • Department of Neurological Surgery, University of Kansas, Kansas City, Kansas, USA. Electronic address: fdestefano@kumc.edu.
    • World Neurosurg. 2022 Oct 1; 166: e590e598e590-e598.

    ObjectiveTo systematically review existing literature on the neurosurgical management and outcomes of brain metastasis from pancreatic cancer in comparison with our institutional experience of this patient cohort.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed using PubMed, Ovid Embase, Scopus, and Web of Science databases from date of database inception to March 2022. Studies were selected based on predetermined inclusion and exclusion criteria. Simultaneously, a retrospective analysis was conducted of patients who underwent neurosurgical evaluation and treatment for intracranial metastatic lesions from pancreatic origin at a single institution.ResultsThe original literature search yielded 292 articles, of which 17 studies comprising 23 patients with brain metastases of pancreatic origin were ultimately selected. Median overall survival from primary diagnosis of pancreatic cancer was 22 months (interquartile range: 3-84) and 3 months (interquartile range: 1-36) after diagnosis of brain metastasis. In our institutional cohort, 4 patients were identified with a median overall survival of 30.5 months (interquartile range: 2-108). Our institutional cohort experienced a prolonged median overall survival (3 months vs. 30.5 months, P = 0.03) compared with the literature.ConclusionsBrain metastasis from pancreatic cancer is rare and associated with a fatal outcome. However, based on the data presented in this review, patient-specific and treatment-related factors could signal better prognosis. Further studies are needed to elucidate multimodal therapy and survival to suggest a more personalized decision-making process.Copyright © 2022 Elsevier Inc. All rights reserved.

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