Skip to main content

Advertisement

SpringerLink
Log in

Pancreatic Metastasis From Renal Cell Carcinoma: Which Patients Benefit From Surgical Resection?

  • Hepatic and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Pancreas is a possible site of metastases from renal cell carcinoma (RCC). The aim of this study was to define the role of surgery in their treatment.

Methods

We retrospectively analyzed 36 patients with pancreatic metastasis from RCC observed between January 1998 and February 2006. Patients were categorized into three risk groups according to the modified Memorial Sloan-Kettering prognostic factors model.

Results

Resective surgery was performed in 23 patients, as follows: 11 distal pancreatectomy, 5 enucleation, 4 pancreatoduodenectomy, 2 total pancreatectomy, and 1 middle pancreatectomy. No perioperative mortality was observed; the morbidity rate was 47.8%. All patients who underwent resection belonged to the favorable risk group. Surgical resection was excluded in 13 cases because of locally advanced disease (2 cases) or extrapancreatic disease (11 cases); 5 of these patients were at favorable, 7 at intermediate, and 1 at poor risk. In patients undergoing surgery, the 5-year actuarial survival rate was 88%, and median disease-free survival was 44 months. Patients who did not undergo surgery had a 5-year survival rate of 47%, with a median survival time of 27 months (P = .02).

Conclusions

Patients with pancreatic metastases from RCC belonging to a favorable risk group are candidates for resection, even in the presence of another metastatic site or multifocal pancreatic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

Reference

  1. Roland CF, van Heerden JA. Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet 1989;168:345–7

    PubMed  CAS  Google Scholar 

  2. Z’graggen K, Fernandez-del Castillo C, Rattner DW, et al. Metastases to the pancreas and their surgical extirpation. Arch Surg 1998;133:413–8

    Article  PubMed  CAS  Google Scholar 

  3. Faure JP, Tuech JJ, Richer JP, et al. Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. J Urol 2001;165:20–2

    Article  PubMed  CAS  Google Scholar 

  4. Bassi C, Butturini G, Falconi M, et al. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma. Br J Surg 2003;90:555–9

    Article  PubMed  CAS  Google Scholar 

  5. Sellner F, Tykalsky N, De Santis M, et al. Solitary and multiple isolated metastases of clear cell carcinoma to the pancreas: an indication for pancreatic surgery. Ann Surg Oncol 2006;13:75–85

    Article  PubMed  Google Scholar 

  6. Thompson L, Heffess C. Renal cell carcinoma to the pancreas in surgical pathology material. A clinicopathological study with 21 cases with a review of the literature. Cancer 2000;89:1076–88

    Article  PubMed  CAS  Google Scholar 

  7. Sohn TA, Yeo CJ, Cameron JL, et al. Renal cell carcinoma metastatic to the pancreas: results of surgical management. J Gastrointest Surg 2001;5:346–51

    Article  PubMed  CAS  Google Scholar 

  8. Law CH, Wei AC, Hanna SS, et al. Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment, and outcome. Ann Surg Oncol 2003;10:922–6

    Article  PubMed  Google Scholar 

  9. Sperti C, Pasquali C, Liessi G, et al. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol 2003;83:161–6

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. Sotiropoulos GC, Lang H, Liu C, et al. Surgical treatment of pancreatic metastases of renal cell carcinoma. J Pancreas 2005;6:339–43

    Google Scholar 

  12. Wente MN, Kleeff J, Esposito I, et al. Renal cancer cell metastasis into the pancreas. A single-center experience and overview of the literature. Pancreas 2005;30:218–22

    Article  PubMed  Google Scholar 

  13. Atkins MB, Avigan DE, Bukowski RM, et al. Innovations and challenges in renal cancer: consensus statement from the first international conference. Clin Cancer Res 2004;10:6277s–81s

    Article  PubMed  Google Scholar 

  14. Motzer RJ, Mazumdar M, Bacik J, et al. Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol 1999;17:2530–40

    PubMed  CAS  Google Scholar 

  15. Atzpodien J, Royston P, Wandert T, et al, and the DGCIN–German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Group. Metastatic renal carcinoma comprehensive prognostic system. Br J Cancer 2003;88:348–53

    Article  PubMed  CAS  Google Scholar 

  16. Leibovich BC, Cheville JC, Lohse CM, et al. A scoring algorithm to predict survival for patients with metastatic clear cell renal cell carcinoma: a stratification tool for prospective clinical trials. J Urol 2005;174:1759–63

    Article  PubMed  Google Scholar 

  17. Motzer RJ, Bacik J, Schwartz LH, et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 2004;22:454–63

    Article  PubMed  Google Scholar 

  18. Mekhail TM, Abou-Jawde RM, Boumerhi G, et al. Validation and extension of the Memorial Sloan-Kettering prognostic factors model for survival in patients with previously untreated metastatic renal cell carcinoma. J Clin Oncol 2005;23:832–41

    Article  Google Scholar 

  19. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an International Study Group (ISGPF) definition. Surgery 2005;138:8–13

    Article  PubMed  Google Scholar 

  20. Kaplan E, Meier P. Non-parametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–81

    Article  Google Scholar 

  21. Jemal A, Murray T, Ward E, et al. Cancer statistics. CA Cancer J Clin 2005;55:10–30

    Article  PubMed  Google Scholar 

  22. Javidan J, Stricker HJ, Tamboli P, et al. Prognostic significance of the 1997 TNM classification of renal cell carcinoma. J Urol 1999;162:1277–81

    Article  PubMed  CAS  Google Scholar 

  23. Pantuck AJ, Zisman A, Belldegrun AS. The changing natural history of renal cell carcinoma. J Urol 2001;166:1611–23

    Article  PubMed  CAS  Google Scholar 

  24. Janzen NK, Kim HL, Figlin RA, et al. Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. Urol Clin North Am 2003;30:843–52

    Article  PubMed  Google Scholar 

  25. Motzer RJ, Bander NH, Nanus DM. Renal-cell carcinoma. N Engl J Med 1996;335:865–75

    Article  PubMed  CAS  Google Scholar 

  26. Figlin RA. Renal cell carcinoma: management of advanced disease. J Urol 1999;161:381–6

    Article  PubMed  CAS  Google Scholar 

  27. Motzer RJ, Russo P. Systemic therapy for renal cell carcinoma. J Urol 2000;163:408–17

    Article  PubMed  CAS  Google Scholar 

  28. Nakeeb A, Lillemoe KD, Cameron JL. The role of pancreaticoduodenectomy for locally recurrent or metastatic carcinoma to the periampullary region. J Am Coll Surg 1995;180:188–92

    PubMed  CAS  Google Scholar 

  29. Kierney PC, van Heerden JA, Segura JW, et 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

    Article  PubMed  CAS  Google Scholar 

  30. Pogrebniak HW, Haas G, Linehan WM, et al. Renal cell carcinoma: resection of solitary and multiple metastases. Ann Thorac Surg 1992;54:33–8

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

The authors thank M. Frasson for help with English-language revision.

Author information

Authors and Affiliations

  1. Pancreas Unit, Department of Surgery, S. Raffaele Scientific Institute, V. Olgettina 60, 20132, Milan, Italy

    Alessandro Zerbi MD, Enrico Ortolano MD, Gianpaolo Balzano MD, Aldo Alberto Beneduce MD & Valerio Di Carlo MD

  2. Department of Oncology, S. Raffaele Scientific Institute, V. Olgettina 60, 20132, Milan, Italy

    Anna Borri MD

Authors
  1. Alessandro Zerbi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enrico Ortolano MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gianpaolo Balzano MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Borri MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aldo Alberto Beneduce MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Valerio Di Carlo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alessandro Zerbi MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zerbi, A., Ortolano, E., Balzano, G. et al. Pancreatic Metastasis From Renal Cell Carcinoma: Which Patients Benefit From Surgical Resection?. Ann Surg Oncol 15, 1161–1168 (2008). https://doi.org/10.1245/s10434-007-9782-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-007-9782-0

Keywords

Search

Navigation