Pancreatic Resection for Metastatic Renal Cell Carcinoma


Authors: M. Varga 1;  M. Oliverius 1;  A. Valsamis 1;  M. Kučera 1;  R. Gürlich 2;  M. Šafanda 3;  I. Matia 1;  E. Honsová 4
Authors‘ workplace: Klinika transplantační chirurgie, Institut klinické a experimentální medicíny, Praha 1;  Chirurgická klinika, Fakultní nemocnice Královské Vinohrady, Praha 2;  Oddělení klinické onkologie, Nemocnice Na Homolce, Praha 3;  Pracoviště klinické a transplantační patologie, Institut klinické a experimentální medicíny, Praha 4
Published in: Klin Onkol 2009; 22(6): 288-290
Category: Case Reports

Overview

Backgrounds:
Late metastases of renal cell carcinoma (RCC) are quite common. However, meta­stases in the pancreas are rare. Between 2004– 2008 the Department of transplantation surgery of the institute of clinical and experimental medicine performed 87 pancreatic resections for tumour. From this, metastasis of RCC was histologically verified in four cases. The aim of this study was to summarize in the form of brief case reports our experience with the surgical treatment of pancreatic metastasis of RCC.

Observation:
The interval from nephrectomy to the occurrence of pancreatic metastasis was 10, 11, 15 and 16 years. All patients were examined to exclude metastatic generalization. Surgical treatment was: one total pancreatectomy, two subtotal pancreatectomies and one caudal resection. Two patients had solitary pancreatic metastasis, one had two metastases and one had multiple metastatic lesions. No complications were observed in the postoperative period. All patients are living with survival time of 7, 23, 26 and 52 months. None of them has signs of recurrence of the primary disease.

Conclusion:
The follow up in patients with a history of RCC should be lifelong. Considering the low response of RCC and its metastases to oncological treatment, pancreatic resection is a safe method with a low rate of complications in patients with RCC metastases limited only to the pancreas and detected in time.

Key words:
renal cancer – clear cell renal carcinoma –  metastasis –  pancreas – metastasectomy


Sources

1. Tolia BM, Whitmore WF Jr. Solitary metastasis from renal cell carcinoma. J Urol 1975; 114(6): 836– 838.

2. Pantuck AJ, Zisman A, Belldegrun AS. The changing natural history of renal cell carcinoma. J Urol 2001; 166(5): 1611– 1623.

3. Escudier B, Eisen T, Stadler WM et al. Sorafenib for Treatment of Renal Cell Carcinoma: Final Efficacy and Safety Results of the Phase III Treatment Approaches in Renal Cancer Global Evaluation Trial. J Clin Oncol 2009; 27: 3312–3318.

4. Sohn TA, Yeo CJ, Cameron JL et al. Renal cell carcinoma metastatic to the pancreas: results of surgical management. J Gastrointest Surg 2001; 5(4): 346– 351.

5. Sweeney AD, Wu MF, Hilsenbeck SG et al. Value of Pancreatic Resection for Cancer Metastatic to the Pancreas. J Surg Res 2009; 156(2): 189–198.

6. Palmowski M, Hacke N, Satzl S et al. Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology 2008; 8(2): 199– 203.

7. Alexakis N, Halloran C, Raraty M et al. Current standards of surgery for pancreatic cancer. Br J Surg 2004; 91(11): 1410– 1427.

8. Yeo CJ, Cameron JL, Sohn TA et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 1997; 226(3): 248– 257, discussion 257– 260.

9. Volk A, Kersting S, Konopke R et al. Surgical therapy of intrapancreatic metastasis from renal cell carcinoma. Pancreatology 2009; 9(4): 392– 397.

10. Kavolius JP, Mastorakos DP, Pavlovich C et al. Resection of metastatic renal cell carcinoma. J Clin Oncol 1998; 16(6): 2261– 2266.

11. Šiffnerová H, Bustová I. Prognostické faktory u metastatických nádorů ledvin. Klin Onkol 2005; 18(6): 216– 218.

Labels
Paediatric clinical oncology Surgery Clinical oncology
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