Stellenwert der Metastasenchirurgie beim fortgeschrittenen Pankreaskarzinom

Background: According to the current guidelines surgery is not recommended in the metastasized stage of pancreatic cancer; however, in clinical practice surgery including resection of the primary tumor and metastases is performed in individual cases. Aim: This review article summarizes the currently available evidence based on the published studies. Material and methods: A systematic search in MEDLINE and PubMed was performed with respect to metastasized pancreatic cancer and surgical resection. Results: The evidence level is not sufficient to answer the question as to whether patients in an oligometastasized stage should be operated on or not. The available retrospective studies show a technical feasibility of synchronous resection of the primary tumor and metastases with a possibly beneficial oncological outcome for specific patient groups. Conclusion: Based on the currently available evidence, a general treatment decision for patients in an oligometastatic stage cannot be derived. Therefore, prospective clinical trials are necessary to answer the question of which patients could benefit from a combined resection of primary tumor and metastases embedded in a multimodal treatment concept.