Background

The pancreas is a rare site of metastases, although metastatic renal cell carcinoma (mRCC) is the most commonly reported secondary tumor. Pancreatectomy has been described in selected patients with localized metastases, but long-term benefit remains poorly defined.

Methods

A retrospective review of a prospectively maintained database was performed to evaluate the outcomes of patients undergoing pancreatectomy for mRCC at a tertiary care center from 1995–2017. Postoperative complications were evaluated using the Modified Accordion Grading System (MAGS) and Kaplan–Meier curves and log-rank tests were utilized for survival analysis.

Results

29 patients underwent pancreatectomy for mRCC including 15 distal pancreatectomies (DP), 10 pancreaticoduodenectomies (PD) and 4 total-pancreatectomies (TP). The mean age was 67 ± 8 years, and 15 were male. The median time from index nephrectomy to pancreatectomy was 8 (IQR: 3.72–12.2) years. There was no 90 Day post-pancreatectomy mortalities and the morbidity incidence included 13 Minor MAGS and 8 Severe MAGS complications respectively. Post-pancreatectomy disease specific survival at 2- and 4-years were 89% and 80% with 12 patients being alive at last follow up.

Conclusions

Pancreatic resection can be safely performed in select patients with localized mRCC with favorable long-term outcomes.

中文翻译：

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胰腺切除术治疗转移性肾细胞癌已有22年的经验。

背景

胰腺是罕见的转移部位，尽管转移性肾细胞癌（mRCC）是最常报告的继发性肿瘤。胰腺切除术已在部分转移灶的特定患者中进行了描述，但长期获益尚不清楚。

方法

回顾性审查了一个前瞻性维护的数据库，以评估1995-2017年在三级护理中心接受胰腺切除术治疗mRCC的患者的结局。使用改良的手风琴评分系统（MAGS）和Kaplan-Meier曲线评估术后并发症，并采用对数秩检验进行生存分析。

结果

29例行mRCC胰腺切除术的患者包括15例远端胰腺切除术（DP），10例胰十二指肠切除术（PD）和4例全胰腺切除术（TP）。平均年龄为67±8岁，男性为15岁。从指标肾切除术到胰腺切除术的中位时间为8年（IQR：3.72-12.2）。胰腺切除术后无90天死亡率，发病率分别包括13例轻微的MAGS和8例严重的MAGS并发症。胰腺切除术后2年和4年的特定生存率分别为89％和80％，最后一次随访还活着12例患者。

结论

胰腺切除术可在部分mRCC局限且长期预后良好的患者中安全地进行。