Surgical therapy of intrapancreatic metastasis from renal cell carcinoma.
BACKGROUND
Pancreatic metastases from renal cell carcinoma (RCC) are clinically rare but highly resectable. The aim of this article is to identify patients who profit from pancreatic resection of RCC despite the invasiveness of the surgery.


METHODS
Between January 1996 and December 2007, data from 744 patients were collected in a prospective pancreatic surgery database, and patients with metastasis into the pancreas from RCC were identified.


RESULTS
Resective surgery was performed in 14 patients with metastasis to the pancreas from RCC. Most patients were clinically asymptomatic. The median interval between primary treatment of RCC and occurrence of pancreatic metastasis was 94 months (range 32-158). The morbidity rate was 42.8%. Patients with a metastasis size <2.5 cm had a much better survival after resection (100 months) than those with a metastasis size >2.5 cm (44 months). Moreover, the number of metastases predicts the survival after resection.


CONCLUSIONS
In patients with pancreatic metastases from RCC who have only limited disease, complete resection of all lesions can be successfully performed with a low rate of complications. Thus, patients with a history of RCC should be monitored for more than 10 years after nephrectomy to detect recurrence.
Volk
Andreas
A
Department of General, Thoracic and Vascular Surgery, University of Dresden, Dresden, Germany. andreas.volk@uniklinikum-dresden.de
Kersting
Stephan
S
Konopke
Ralf
R
Dobrowolski
Frank
F
Franzen
Stefan
S
Ockert
Detlef
D
Grutzmann
Robert
R
Saeger
Hans Detlev
HD
Bergert
Hendrik
H
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome