title: Pancreatic metastasis from clear cell renal cell carcinoma: outcome of an aggressive approach.
abstract: OBJECTIVE
  To evaluate the long-term results of patients surgically treated for metastatic clear cell renal cell carcinoma (CCRCC) with a unique pancreatic secondary localization to assess the importance of radical treatment in this rare group of patients.
  
  
  METHODS
  This is a retrospective monocentric study including 20 surgically treated patients between 1997 and 2012 for a unique pancreatic metastasis of a CCRCC. The main objective was to evaluate the outcome after surgical resection.
  
  
  RESULTS
  Twenty patients were followed up for a CCRCC. The M/F ratio was 1.2. The average age of onset of kidney cancer was 57.05 ± 7.78 years. Two patients who had synchronous pancreatic metastasis and 18 patients who had metachronous metastasis appeared after an average of 130 ± 59 months (24-240 months). The average size of the metastases was 20 ± 11.6 mm. Pancreatic metastasis was unique in all patients, with 35% of patients having multiple lesions of the pancreas. All patients underwent a pancreatic resection of metastasis. Histologic examination confirmed the location of a secondary CCRCC in all patients. Median follow-up after pancreatectomy was 69 months (1-150 months). Disease-free survival at 2 years was 60%. Overall survival rates at 2 and 4 years were 79% and 72%, respectively. There was no difference found between patients with multiple and unique pancreatic metastases in overall survival.
  
  
  CONCLUSIONS
  Unique pancreatic metastasis of CCRCC is rare. The literature on this subject is limited. Surgical resection might be an option and can be associated with long-term disease-free intervals in highly selected patients.
authors.affiliation: Department of Urology, Strasbourg University Hospital, Strasbourg, France. Electronic address: raphaelbenhaim@hotmail.com.
authors.forename: Raphael
authors.initials: R
authors.lastname: Benhaim
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.affiliation: Department of Urology, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Saeedi
authors.affiliation: Department of Urology, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mouracade
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.affiliation: Department of Urology, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Lang
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome