Is liver resection in metastases of exocrine pancreatic carcinoma justified?

From 1971 to 1995 we have performed 23 liver resections in 22 patients because of hepatic metastases of pancreatic (n = 20) or ampullary (n = 2) carcinomas. In 16 patients the hepatic secondaries were removed synchronously with the pancreatic primary tumour. In 7 cases liver resection was performed for metachronous metastases. Only one patient died after simultaneous resection of liver and pancreas (operative lethality 4,3%). Curative R0-resection was accomplished in 69% of patients with synchronous and 100% with metachronous liver metastases. The median survival time was 8,3 months after synchronous and 5,8 months after metachronous hepatic resection. The one-year survival amounted to 41 and 40% resp. Though distant metastases are a definite sign of a progressed tumour stage, the prognosis of patients with hepatic metastases should not be considered hopeless. In view of a comparatively small operative risk there is a chance for individual patients to gain valuable survival time.