title: Long-term survival after pancreatic resection for renal cell carcinoma metastasis.
abstract: BACKGROUND
  Surgical resection of pancreatic metastasis (PM) is the only reported curative treatment for renal cell carcinoma. However, there is currently little information regarding very long-term survival. The primary objective of this study was to determine the 10-year survival of this condition using the largest surgical series reported to date.
  
  
  METHODS
  Between May 1987 and June 2003, we conducted a retrospective study of 62 patients surgically treated for PM from renal cell carcinoma at 12 Franco-Belgian surgical centers. Follow-up ended on May 31, 2012.
  
  
  RESULTS
  There were 27 male (44 %) and 35 female (56 %) patients with a median age of 54 years [31-75]. Mean disease-free interval from resection of primary tumor to reoperation for pancreatic recurrence was 9.8 years (median 10 years [0-25]). During a median follow-up of 91 months [12-250], 37 recurrences (60 %) were observed. After surgical resection of repeated recurrences, overall median survival time was 52.6 months versus 11.2 months after nonoperative management (p = 0.019). Cumulative 3-, 5-, and 10-year overall survival (OS) rates were 72, 63, and 32 %, respectively. The corresponding disease-free survival rates were 54, 35, and 27 %, respectively. Lymph node involvement and existence of extrapancreatic metastases before PM were associated with poor overall survival.
  
  
  CONCLUSIONS
  Aggressive surgical management of single or multiple PM, even in cases of extrapancreatic disease, should be considered in selected patients to allow a chance of long-term survival.
authors.affiliation: Department of Digestive Surgery, Hôpital Charles Nicolle, Rouen, France.
authors.forename: L
authors.initials: L
authors.lastname: Schwarz
authors.forename: A
authors.initials: A
authors.lastname: Sauvanet
authors.forename: N
authors.initials: N
authors.lastname: Regenet
authors.forename: J Y
authors.initials: JY
authors.lastname: Mabrut
authors.forename: J F
authors.initials: JF
authors.lastname: Gigot
authors.forename: E
authors.initials: E
authors.lastname: Housseau
authors.forename: B
authors.initials: B
authors.lastname: Millat
authors.forename: M
authors.initials: M
authors.lastname: Ouaissi
authors.forename: B
authors.initials: B
authors.lastname: Gayet
authors.forename: D
authors.initials: D
authors.lastname: Fuks
authors.forename: J J
authors.initials: JJ
authors.lastname: Tuech
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate