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Nephrology Xagena

Patients with renal metastases to the pancreas in the era of tyrosine kinase inhibitors: surgical resection does not improve survival


The aim of a study was to compare survival of resected and unresected patients in a large cohort of patients with metastases to the pancreas from renal cell carcinoma ( PM-RCC ).

Data from 16 Italian centers involved in the treatment of metastatic renal cell carcinoma were retrospectively collected.

Overall, 103 consecutive patients with radically resected primary tumors were enrolled in the analysis.

Pancreatic metastases from renal cell carcinoma were synchronous in only three patients ( 3% ). In 56 patients ( 54% ), the pancreas was the only metastatic site, whereas in the other 47 patients, lung ( 57% ), lymph nodes ( 28% ), and liver ( 21% ) were the most common concomitant metastatic sites.

Median time for pancreatic metastases from renal cell carcinoma occurrence was 9.6 years ( range 0-24 years ) after nephrectomy.

Surgical resection of pancreatic metastases from renal cell carcinoma was performed in 44 patients ( median overall survival: 103 months ), while 59 patients were treated with tyrosine kinase inhibitors ( TKIs; median overall survival: 86 months ) ( p = 0.201 ).

At multivariate analysis, Memorial Sloan Kettering Cancer Center risk group was the only independent prognostic factor. None of the other clinical variables, such as age, sex, pancreatic surgery, or the presence of concomitant metastases, were significantly associated with outcome in patients with pancreatic metastases from renal cell carcinoma.

In conclusion, the presence of pancreatic metastases from renal cell carcinoma is associated with a long survival, and surgical resection does not improve survival in comparison with TKI therapy.
However, surgical resection leads to a percentage of disease-free patients with pancreatic metastases from renal cell carcinoma. ( Xagena )

Santoni M et al, Ann Surg Oncol 2015; 22: 2094-2100

XagenaMedicine_2015



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