TY - JOUR
T1 - Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)
AU - Blanco-Fernández, Gerardo
AU - Fondevila, Constantino
AU - Sanjuanbenito, Alfonso
AU - Fabregat-Prous, Joan
AU - Secanella-Medayo, Luís
AU - Rotellar-Sastre, Fernando
AU - Pardo-Sánchez, Fernando
AU - Prieto-Calvo, Mikel
AU - Marín-Ortega, Héctor
AU - Sánchez-Cabús, Santiago
AU - Diez-Valladares, Luis
AU - Alonso-Casado, Óscar
AU - González-Serrano, Carmen
AU - Rodríguez-Sanjuan, Juan Carlos
AU - García-Plaza, Gabriel
AU - Jaén-Torrejimeno, Isabel
AU - Suárez-Muñoz, Miguel Ángel
AU - Becerra-Massare, Antonio
AU - Serna-del Rio, Paula
AU - Pando, Elizabeth
AU - López-Andújar, Rafael
AU - Muñoz-Forner, Elena
AU - Rodriguez-López, Mario
AU - Pereira, Fernando
AU - Serrablo-Requejo, Alejandro
AU - Sánchez Turrión, Víctor
AU - Jiménez Garrido, Manuel
AU - Burdío, Fernando
AU - Martín-Pérez, Elena
AU - Estevan-Estevan, Rafael
AU - López-Guerra, Diego
AU - Castell-Gómez, José
AU - Salinas-Gómez, Javier
AU - López-Baena, Jose Ángel
AU - López-Ben, Santiago
AU - Solar-García, Lorena
AU - Pérez-Alonso, Alejandro J.
AU - Martínez-Insfran, Luis Alberto
AU - Blas, Juan Luis
AU - Cornejo, Marian
AU - Gutiérrez Calvo, Alberto
AU - Domingo- del Pozo, Carlos
AU - Ochando-Cerdan, Federico
AU - Muñoz-Bellvís, Luis
AU - Rebollar-Saenz, José
AU - Sánchez, Belinda
AU - Jover, José María
AU - Gómez-Bravo, Miguel Ángel
AU - Ramia, José M.
AU - Rojas-Holguín, Adela
PY - 2022
Y1 - 2022
N2 - Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival.
AB - Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival.
KW - Renal cell carcinoma
KW - Pancreatectomy
KW - Metastases
KW - Recurrence
U2 - 10.1016/j.ejso.2021.08.011
DO - 10.1016/j.ejso.2021.08.011
M3 - Article
C2 - 34417061
SN - 0305-7399
VL - 48
SP - 133
EP - 141
JO - Clinical Oncology
JF - Clinical Oncology
IS - 1
ER -