Abstract
Background: The diverse natural history of renal cell carcinoma (RCC) includes metastases to the pancreas, a very unusual site for distant spread of other cancers. Considering the relatively indolent behavior of some cases of metastatic RCC, pancreatic resection is offered to select patients.
Methods: We reviewed the records of patients at three affiliated university hospital centers who had prior nephrectomy for RCC and subsequent pancreatic resection of metastases.
Results: Fourteen patients—9 women and 5 men with a median age of 63.8 years—underwent a total of 15 pancreatic resections for metastatic RCC. Nine (64%) had solitary metastases. The median interval from nephrectomy to diagnosis of pancreatic metastases was 83 months. The median size of metastases was 4.6 cm. There was one perioperative death. Pancreatic recurrence occurred in five patients (36%), and one patient underwent repeat resection. At a median follow-up of 32 months, seven patients (50%) are alive without evidence of disease, and four patients (28%) are alive with recurrent disease.
Conclusions: Resection of pancreatic metastases from RCC is associated with long-term survival and should be considered for patients in whom complete resection is possible.
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REFERENCES
Sohn TA, Yeo CJ, Cameron JL, Nakeeb A, Lillemoe KD. Renal cell carcinoma metastatic to the pancreas: results of surgical management. J Gastrointest Surg 2001;5:346–51.
Kierney PC, van Heerden JA, Segura JW, Weaver AL. Surgeon’s role in the management of solitary renal cell carcinoma metastases occurring subsequent to initial curative nephrectomy: an institutional review. Ann Surg Oncol 1994;1:345–52.
Takashi M, Takagi Y, Sakata T, Shimoji T, Miyake K. Surgical treatment of renal cell carcinoma metastases: prognostic significance. Int Urol Nephrol 1995;27:1–8.
Stankard CE, Karl RC. The treatment of isolated pancreatic metastases from renal cell carcinoma: a surgical review. Am J Gastroenterol 1992;87:1658–60.
Faure JP, Tuech JJ, Richer JP, Pessaux P, Arnaud JP, Carretier M. Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. J Urol 2001;165:20–2.
Hiotis SP, Klimstra DS, Conlon KC, Brennan MF. Results after pancreatic resection for metastatic lesions. Ann Surg Oncol 2002;9:675–9.
Fabre JM, Rouanet P, Dagues F, Blanc F, Baumel H, Domergue J. Various features and surgical approach of solitary pancreatic metastasis from renal cell carcinoma. Eur J Surg Oncol 1995;21:683–6.
Ghavamian R, Klein KA, Stephens DH, et al. Renal cell carcinoma metastatic to the pancreas: clinical and radiological features. Mayo Clin Proc 2000;75:581–5.
Hirota T, Tomida T, Iwasa M, Takahashi K, Kaneda M, Tamaki H. Solitary pancreatic metastasis occurring eight years after nephrectomy for renal cell carcinoma. A case report and surgical review. Int J Pancreatol 1996;19:145–53.
Robbins EG, Franceschi D, Barkin JS. Solitary metastatic tumors to the pancreas: a case report and review of the literature. Am J Gastroenterol 1996;91:2414–7.
Kaplan E, Meier P. Non-parametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–81.
Klein KA, Stephens DH, Welch TJ. CT characteristics of metastatic disease of the pancreas. Radiographics 1998;18:369–78.
Rumancik WM, Megibow AJ, Bosniak MA, Hilton S. Metastatic disease to the pancreas: evaluation by computed tomography. J Comput Assist Tomogr 1984;8:829–34.
Hughes JH, Jensen CS, Donnelly AD, et al. The role of fine-needle aspiration cytology in the evaluation of metastatic clear cell tumors. Cancer 1999;87:380–9.
Ishikura K, Yoshida N, Hasegawa M, et al. Clinical study of renal cell carcinoma invading adjacent organs. Hinyokika Kiyo 1994;40:373–7.
Jingu K, Watanabe K, Yamamoto H, et al. Surgical treatment of a solitary pancreatic metastasis from renal cell carcinoma: report of a case. Surg Today 1998;28:91–4.
Kanai T, Aoki A, Okazeri S, et al. Successful aggressive treatment against multiple intra-abdominal metastases from renal cell carcinoma 18 years after nephrectomy. Jpn J Clin Oncol 1992;22:216–20.
Kassabian A, Stein J, Jabbour N, et al. Renal cell carcinoma metastatic to the pancreas: a single-institution series and review of the literature. Urology 2000;56:211–5.
Ng CS, Loyer EM, Iyer RB, David CL, DuBrow RA, Charnsangavej C. Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT. AJR Am J Roentgenol 1999;172:1555–9.
Walsh PC, Retik AC, Darracott Vaughan E Jr, Wein AJ. Campbell’s Urology. 8th ed. St. Louis: Saunders, 2002.
Ritchie AW, DeKernion JB. The natural history and clinical features of renal carcinoma. Semin Nephrol 1987;7:131–9.
Kavolius JP, Mastorakos DP, Pavlovich C, Russo P, Burt ME, Brady MS. Resection of metastatic renal cell carcinoma. J Clin Oncol 1998;16:2261–6.
Conlon KC, Klimstra DS, Brennan MF. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Ann Surg 1996;223:273–9.
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Law, C.H.L., Wei, A.C., Hanna, S.S. et al. Pancreatic Resection for Metastatic Renal Cell Carcinoma: Presentation, Treatment, and Outcome. Ann Surg Oncol 10, 922–926 (2003). https://doi.org/10.1245/ASO.2003.02.003
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DOI: https://doi.org/10.1245/ASO.2003.02.003