title: Pancreatic resection for metastases from renal cancer: long term outcome after surgery and immunotherapy approach - single center experience.
abstract: OBJECTIVE
  Natural history of renal cell carcinoma includes metastases to the pancreas. The literature reports that selected patients may have benefits by pancreatic resection in terms of long term survival. We report patient outcome and considerations on immunotherapy approach.
  
  
  METHODS
  From 2001 to 2010 eight patients underwent pancreatic resection for metastases from renal cancer. We reviewed surgical outcome and following treatment (conventional chemotherapy: 5FU-Vindesine; Immunotherapy: Interleukin 2 - Interferon - Dendritic cells) of these patients.
  
  
  RESULTS
  All patients underwent radical pancreatic resection (7 spleno-pancreatectomies; 1 segmental pancreatic resection) and were R0 after surgery. No postoperative mortality was reported. Morbidity was 37% (2 distal leakage; 1 pneumonitis). Two patients did not receive any further treatment; 2 patients received conventional chemotherapy; 2 patients received immunotherapy (interleukin2 + interferon); 2 patients received dendritic cells (DC) interleukin-2 infusion. Three years overall survival rate was 55%. Disease free survival after 3 years was 30%.
  
  
  CONCLUSIONS
  Our data confirm that pancreatic resection should be offered to selected patients with no mortality and low morbidity. Long-term survival is achievable, but recurrence rate after surgery is high. Immunotherapy could be effective to control tumour progression especially in selected cases where DC may be used.
authors.affiliation: Department of Gastrointestinal and General Surgery, L Pierantoni Hospital, Forli, Italy. andrea.gardini@ausl.fo.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Gardini
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgagni
authors.forename: Carlo
authors.initials: C
authors.lastname: Milandri
authors.forename: Angela
authors.initials: A
authors.lastname: Riccobon
authors.forename: Ruggero
authors.initials: R
authors.lastname: Ridolfi
authors.forename: Giuliano
authors.initials: G
authors.lastname: La Barba
authors.forename: Luca
authors.initials: L
authors.lastname: Saragoni
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.forename: Domenico
authors.initials: D
authors.lastname: Garcea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects; D007558:Italy; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D059146:Metastasectomy / Q000009:adverse effects; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D018579:Patient Selection; D012189:Retrospective Studies; D013156:Splenectomy; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome