Pancreatic metastases (PM) from renal cell carcinoma (RCC) are uncommon. We herein describe the long-term outcomes associated with pancreatectomy at two academic institutions, with a specific focus on 10-year survival.
This investigation was limited to patients undergoing pancreatectomy for PM between 2000 and 2008 at the University of Verona and Memorial Sloan Kettering Cancer Center, allowing a potential for 10 years of surveillance. The probabilities of further RCC recurrence and RCC-related death were estimated using a competing risk analysis (method of Fine and Gray) to account for patients who died of other causes during follow-up.
The study population consisted of 69 patients, mostly with isolated metachronous PM (77%). The median interval from nephrectomy to pancreatic metastasectomy was 109 months, whereas the median post-pancreatectomy follow-up was 141 months. The 10-year cumulative incidence of new RCC recurrence was 62.7%. In the adjusted analysis, the relative risk of repeated recurrence was significantly higher in PM synchronous to the primary RCC (sHR = 1.27) and in patients receiving extended pancreatectomy (sHR = 3.05). The 10-year cumulative incidence of disease-specific death was 25.5%. The only variable with an influence on disease-specific death was the recurrence-free interval following metastasectomy (sHR = 0.98). In patients with repeated recurrence, the 10-year cumulative incidence of RCC-related death was 35.4%.
In a selected group of patients followed for a median of 141 months and mostly with isolated metachronous PM, resection was associated with a high possibility of long-term disease control in surgically fit patients with metastases confined to the pancreas.
Annals of surgical oncology. 2021 Feb 11 [Epub ahead of print]
Giuseppe Malleo, Roberto Salvia, Laura Maggino, Giovanni Marchegiani, Michael D'Angelica, Ronald DeMatteo, Peter Kingham, Alessandra Pulvirenti, Elisabetta Sereni, William R Jarnagin, Claudio Bassi, Peter J Allen, Giovanni Butturini
Unit of General and Pancreatic Surgery-DSCOMI University of Verona, Verona, Italy. ., Unit of General and Pancreatic Surgery-DSCOMI University of Verona, Verona, Italy., Unit of General and Pancreatic Surgery, Department of Surgery and Oncology, University of Verona Hospital Trust, Verona, Italy., The Hepato-Biliary and Pancreatic Unit, Memorial Sloan Kettering Cancer Center, New York, NY, USA.