Clinicopathologic features and treatment strategies for patients with pancreatic adenocarcinoma and ovarian metastases

Background.Ovarian metastases from pancreatic adenocarcinoma are uncommon and data on the clinical features, treatment, and survival of patients with pancreatic adenocarcinoma with ovarian metastases is limited. The purpose of this study is to define the clinical characteristics and treatment strategies for this patient population.Methods.We reviewed the charts of 18 patients with pancreatic adenocarcinoma with ovarian metastasis who had presented to The University of Texas M. D. Anderson Cancer Center from 1985 to 2005.Results.Of the 18 patients diagnosed with pancreatic adenocarcinoma and ovarian metastases, 8 (44%) presented with ovarian metastases initially and a pancreatic primary tumor became apparent only on further imaging or during surgery. On pathology review, the primary pancreatic cancers (5 out of 18) and ovarian metastases (8 out of 16) showed mucinous characteristics. Patients who underwent resection of their ovarian metastases followed by chemotherapy had a trend of longer median survival compared to patients who received chemotherapy alone without resection of the ovarian metastases (16.5 vs. 8.5 months, respectively; p = 0.28). Patients who responded to chemotherapy had a trend of longer survival compared to nonresponders (19 vs. 6 months, respectively; p = 0.1). No responses were observed in the ovarian metastases to chemotherapy alone.Conclusions.Primary pancreatic adenocarcinoma with synchronous ovarian metastases may present initially as symptomatic ovarian masses and they commonly have mucinous histologic characteristics. Surgical resection of ovarian metastases may play an important palliative role in the treatment of symptomatic patients with good performance status and lead to longer survival.