title: Surgical resection does not improve survival in patients with renal metastases to the pancreas in the era of tyrosine kinase inhibitors.
abstract: BACKGROUND
  The aim of this study was to compare survival of resected and unresected patients in a large cohort of patients with metastases to the pancreas from renal cell carcinoma (PM-RCC).
  
  
  METHODS
  Data from 16 Italian centers involved in the treatment of metastatic RCC were retrospectively collected. The Kaplan-Meier and log-rank test methods were used to evaluate overall survival (OS). Clinical variables considered were sex, age, concomitant metastasis to other sites, surgical resection of PM-RCC, and time to PM-RCC occurrence.
  
  
  RESULTS
  Overall, 103 consecutive patients with radically resected primary tumors were enrolled in the analysis. PM-RCCs were synchronous in only three patients (3 %). In 56 patients (54 %), the pancreas was the only metastatic site, whereas in the other 47 patients, lung (57 %), lymph nodes (28 %), and liver (21 %) were the most common concomitant metastatic sites. Median time for PM-RCC occurrence was 9.6 years (range 0-24 years) after nephrectomy. Surgical resection of PM-RCC was performed in 44 patients (median OS 103 months), while 59 patients were treated with tyrosine kinase inhibitors (TKIs; median OS 86 months) (p = 0.201). At multivariate analysis, Memorial Sloan Kettering Cancer Center risk group was the only independent prognostic factor. None of the other clinical variables, such as age, sex, pancreatic surgery, or the presence of concomitant metastases, were significantly associated with outcome in PM-RCC patients.
  
  
  CONCLUSIONS
  The presence of PM-RCC is associated with a long survival, and surgical resection does not improve survival in comparison with TKI therapy. However, surgical resection leads to a percentage of disease-free PM-RCC patients.
authors.affiliation: Clinica di Oncologia Medica, Università Politecnica delle Marche, AOU Ospedali Riuniti, Ancona, Italy, mattymo@alice.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conti
authors.forename: Stefano
authors.initials: S
authors.lastname: Partelli
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.forename: Cora N
authors.initials: CN
authors.lastname: Sternberg
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
authors.forename: Sergio
authors.initials: S
authors.lastname: Bracarda
authors.forename: Umberto
authors.initials: U
authors.lastname: Basso
authors.forename: Ugo
authors.initials: U
authors.lastname: De Giorgi
authors.forename: Lisa
authors.initials: L
authors.lastname: Derosa
authors.forename: Mimma
authors.initials: M
authors.lastname: Rizzo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.forename: Francesco
authors.initials: F
authors.lastname: Massari
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.forename: Michele
authors.initials: M
authors.lastname: Milella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Buti
authors.forename: Linda
authors.initials: L
authors.lastname: Cerbone
authors.forename: Luciano
authors.initials: L
authors.lastname: Burattini
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Montironi
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases