title: Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis.
abstract: Pancreatic metastases from renal cell carcinoma are uncommon and their prognostic significance is not well defined. In this analysis we evaluated the outcome of patients with pancreatic metastases treated with either targeted therapies or local treatment to the pancreas. Patients with pancreatic metastases from renal cell carcinoma treated between 1993 and 2014 were identified from 11 European centers. Clinical records were retrospectively reviewed. Kaplan-Meier method and log-rank test were used to evaluate progression-free survival and overall survival. Cox's proportional hazard models were used for survival analysis. In total, 276 PM patients were evaluated, including 77 (28%) patients treated by either surgery or radiotherapy to the pancreas, and 256 (93%) who received systemic therapy. Median time from nephrectomy to diagnosis of pancreatic metastases was 91 months (IQR 54-142). Disease control rate after first-line TTs was 84%, with a median progression-free survival of 12 months (95% CI 10-14). Median overall survival was 73 months (95% CI 61-86) with a 5-year OS of 58%. Median OS of patients treated with local treatment was 106 months (95% CI 78-204) with a 5-year overall survival of 75%. On multivariable analysis, nephrectomy (HR 5.31; 95%CI 2.36-11.92; p<0.0001), Memorial Sloan Kettering/International Metastatic RCC Database Consortium prognostic score (HR 1.45, 95% CI 0.94-2.23 for intermediate vs good vs risk; HR 2.76 95%, CI 1.43-5.35 for poor vs good risk p = 0.0099) and pancreatic local treatment (HR 0.48; 95%CI 0.30-0.78 p = 0.0029) were associated with overall survival. Difference in median OS between patients with PM and that reported in a matched-control group of mRCC patients with extrapancreatic metastases was statistically significant (p < .0001). Pancreatic metastases from renal cell carcinoma usually occur years after nephrectomy, are associated with an indolent behavior and a prolonged survival. Targeted therapies and locoregional approaches are active and achieve high disease control rate.
authors.affiliation: Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Grassi
authors.affiliation: Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Doucet
authors.affiliation: Medical Oncology, IRCCS San Matteo University Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
authors.forename: Palma
authors.initials: P
authors.lastname: Giglione
authors.affiliation: Clinic for Haematology, Hemostasis, Oncology and Stemcelltransplantation, Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
authors.forename: Viktor
authors.initials: V
authors.lastname: Grünwald
authors.affiliation: Dept of Oncology, Palacký University Medical School and Teaching Hospital, I.P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.affiliation: Medical Oncology 2, A.O.U.P., Istituto Toscano Tumori, via Roma 67, 56126, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Galli
authors.affiliation: Dept of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, 47014, Meldola, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: De Giorgi
authors.affiliation: Dept of Oncology and Haematology and Respiratory Disease, University Hospital, Via del Pozzo 71, 41124, Modena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sabbatini
authors.affiliation: Medical Oncology 1 - Candiolo Cancer Institute-FPO, IRCCS, Strada Provinciale, 142 km 3,95, 10060, Candiolo, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Ortega
authors.affiliation: Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Via Conca, 71, 60126, Ancona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: Dept of Clinical Therapeutics, Alexandra General Hospital, V. Sofias and Lourou 1 11528, Athens, Greece.
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Bamias
authors.affiliation: Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.affiliation: Medical Oncology 2, A.O.U.P., Istituto Toscano Tumori, via Roma 67, 56126, Pisa, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Derosa
authors.affiliation: Dept of Oncology, Palacký University Medical School and Teaching Hospital, I.P. Pavlova 6, 775 20, Olomouc, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Studentova
authors.affiliation: Medical Statistics, Trial Center, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Pacifici
authors.affiliation: Gastrointestinal Surgery and Liver Transplantation Unit, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Jorgelina
authors.initials: J
authors.lastname: Coppa
authors.affiliation: Gastrointestinal Surgery and Liver Transplantation Unit, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mazzaferro
authors.affiliation: Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: de Braud
authors.affiliation: Medical Oncology, IRCCS San Matteo University Hospital Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
authors.forename: Camillo
authors.initials: C
authors.lastname: Porta
authors.affiliation: Gustave Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Escudier
authors.affiliation: Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, via G. Venezian 1, 20133, Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000401:mortality*; D060787:Neoplasm Grading; D009392:Nephrectomy / Q000401:mortality*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate