A 22-year experience with pancreatic resection for metastatic renal cell carcinoma

HPB (Oxford). 2020 Feb;22(2):312-317. doi: 10.1016/j.hpb.2019.05.019. Epub 2019 Jul 23.

Abstract

Background: The pancreas is a rare site of metastases, although metastatic renal cell carcinoma (mRCC) is the most commonly reported secondary tumor. Pancreatectomy has been described in selected patients with localized metastases, but long-term benefit remains poorly defined.

Methods: A retrospective review of a prospectively maintained database was performed to evaluate the outcomes of patients undergoing pancreatectomy for mRCC at a tertiary care center from 1995-2017. Postoperative complications were evaluated using the Modified Accordion Grading System (MAGS) and Kaplan-Meier curves and log-rank tests were utilized for survival analysis.

Results: 29 patients underwent pancreatectomy for mRCC including 15 distal pancreatectomies (DP), 10 pancreaticoduodenectomies (PD) and 4 total-pancreatectomies (TP). The mean age was 67 ± 8 years, and 15 were male. The median time from index nephrectomy to pancreatectomy was 8 (IQR: 3.72-12.2) years. There was no 90 Day post-pancreatectomy mortalities and the morbidity incidence included 13 Minor MAGS and 8 Severe MAGS complications respectively. Post-pancreatectomy disease specific survival at 2- and 4-years were 89% and 80% with 12 patients being alive at last follow up.

Conclusions: Pancreatic resection can be safely performed in select patients with localized mRCC with favorable long-term outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / surgery*
  • Databases, Factual
  • Female
  • Humans
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology*
  • Kidney Neoplasms / therapy
  • Male
  • Middle Aged
  • Pancreatectomy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / secondary*
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy
  • Retrospective Studies
  • Survival Analysis
  • Survival Rate
  • Time Factors
  • Treatment Outcome