title: Resection of isolated renal cell carcinoma metastases of the pancreas: outcomes from the Johns Hopkins Hospital.
abstract: OBJECTIVE
  This study aims to assess outcomes and characteristics associated with resection of metastatic renal cell carcinoma (mRCC) to the pancreas.
  
  
  METHODS
  From April 1989 to July 2012, a total of 42 patients underwent resection of pancreatic mRCC at our institution. We retrospectively reviewed records from a prospectively managed database and analyzed patient demographics, comorbidities, perioperative outcomes, and overall survival. Cox proportional hazards models were used to evaluate the association between patient-specific factors and overall survival.
  
  
  RESULTS
  The mean time from resection of the primary tumor to reoperation for pancreatic mRCC was 11.2 years (range, 0-28.0 years). In total, 17 patients underwent pancreaticoduodenectomy, 16 underwent distal pancreatectomy, and 9 underwent total pancreatectomy. Perioperative complications occurred in 18 (42.9%) patients; there were two (4.8%) perioperative mortalities. After pancreatic resection, the median follow-up was 7.0 years (0.1-23.2 years), and median survival was 5.5 years (range, 0.4-21.9). The overall 5-year survival was 51.8%. On univariate analysis, vascular invasion (hazard ratio, 5.15; p = 0.005) was significantly associated with increased risk of death.
  
  
  CONCLUSIONS
  Pancreatic resection of mRCC can be safely achieved in the majority of cases and is associated with long-term survival. Specific pathological factors may predict which patients will benefit most from resection.
authors.affiliation: The Department of Surgery, Johns Hopkins Medical Institutions Sol Goldman Pancreatic Research Center, 604 Blalock Building, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Tosoian
authors.forename: J L
authors.initials: JL
authors.lastname: Cameron
authors.forename: M E
authors.initials: ME
authors.lastname: Allaf
authors.forename: R H
authors.initials: RH
authors.lastname: Hruban
authors.forename: C B
authors.initials: CB
authors.lastname: Nahime
authors.forename: T M
authors.initials: TM
authors.lastname: Pawlik
authors.forename: P M
authors.initials: PM
authors.lastname: Pierorazio
authors.forename: S
authors.initials: S
authors.lastname: Reddy
authors.forename: C L
authors.initials: CL
authors.lastname: Wolfgang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D010180:Pancreatectomy / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome