Is there a role for resection of oligometastatic disease in pancreatic ductal adenocarcinoma?

It is estimated that approximately 80%-90% of pancreatic ductal adenocarcinoma (PDAC) will present with unresectable disease with about half of patients presenting with distant metastases. The prognosis of these patients is generally poor with an average life expectancy of approximately 6 months and a median 5-year survival of 1%. The current standard of care for metastatic PDAC patients is palliative chemotherapy, as surgery in this setting does not lead to better survival. More recently, some centers have utilized very specific patient selection to perform resection of oligometastatic disease with reported improvement in survival - with many centers using response to systemic therapy as a sign of favorable biology. We performed a literature review investigating the role of surgical resection of oligometastatic disease of the lung and liver in PDAC.