Pancreatic resection for metastatic renal cell cancer: experience of a high-volume Mexican hospital

Authors

  • Edson Christian García-Castillo Secretaria de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México. México. https://orcid.org/0000-0003-0056-9072
  • Francisco Tomás Rodríguez-Covarrubias Secretaria de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México. México. https://orcid.org/0000-0003-0056-7886
  • Óscar Santes-Jasso Secretaria de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México. México. https://orcid.org/0000-0002-6393-4607
  • Gerardo Tena-González Méndez Secretaria de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México. México. https://orcid.org/0000-0002-7008-3564

DOI:

https://doi.org/10.48193/hxedqd58

Keywords:

renal cell carcinoma, pancreatic metastases, pancreatectomy

Abstract

Objective: The aim of our study was to report the oncological and surgical outcomes of the pancreatic resections due to solitary pancreatic metastasis of RCC in a tertiary care reference center for pancreatic masses in Mexico.

Materials y methods: All pancreatic resections at our Institution from 2002 to 2022 were retrospectively analyzed. We only included patients treated with pancreatic resections due to metastatic RCC to the pancreas. We evaluated symptoms, time from nephrectomy to pancreatic resection, type of surgery, complications and oncological outcomes.

Results: Eight pancreatic resections due to solitary metastases of RCC were performed. The median age of presentation was 69 years. The most prevalent symptom was abdominal pain (50 %). 6 pancreatoduodenectomies (Whipple procedure), 1 distal pancreatectomy and 1 total pancreatomy were done. The median time between radical nephrectomy and pancreatic resection was 122 months (8-247 months). Seven had negative surgical margins. The median follow-up time after pancreatic surgery was 42 months (1-109 months).

The only case that died had pulmonary metastases and the resection was R1.
Originality and value: Original study demonstrating the survival outcomes of pancreatic resection for metastatic renal cell carcinoma in a high-volume hospital in Mexico.

Limitations: Retrospective study and the limited number of cases.

Conclusions: Pancreatic resections due to solitary metastases from CCR could offer some advantages on survival, as long as they are done in high volume centers.

References

Siegel Rl, Miller Kd, Jemal A. Cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69(1). https://doi.org/10.3322/caac.21551.

International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today, México. 2022 p. 2.

Siegel Rl, Miller Kd, Jemal A. Cancer statistics, 2020. CA: a cancer journal for clinicians. 2020;70(1). https://doi.org/10.3322/caac.21590.

Ljungberg B, Campbell Sc, Choi Hy, Jacqmin D, Lee Je, Weikert S, et al. The epidemiology of renal cell carcinoma. European urology. 2011;60(4). https://doi.org/10.1016/j.eururo.2011.06.049.

Janzen Nk, Kim Hl, Figlin Ra, Belldegrun As. Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent disease. The Urologic clinics of North America. 2003;30(4). https://doi.org/10.1016/s0094-0143(03)00056-9.

Bianchi M, Sun M, Jeldres C, Shariat Sf, Trinh Qd, A B, et al. Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Annals of oncology : official journal of the European Society for Medical Oncology. 2012;23(4). https://doi.org/10.1093/annonc/mdr362.

Scatarige Jc, Horton Km, Sheth S, Fishman Ek. Pancreatic parenchymal metastases: observations on helical CT. AJR. American journal of roentgenology. 2001;176(3). https://doi.org/10.2214/ajr.176.3.1760695.

Ascenti G, Visalli C, Genitori A, Certo A, Pitrone A, Mazziotti S. Multiple hypervascular pancreatic metastases from renal cell carcinoma: dynamic MR and spiral CT in three cases. Clinical imaging. 2004;28(5). https://doi.org/10.1016/S0899-7071(03)00198-0.

Law Ch, Wei Ac, Hanna Ss, Al-Zahrani M, Taylor Br, Pd G, et al. Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment, and outcome. Annals of surgical oncology. 2003;10(8). https://doi.org/10.1245/aso.2003.02.003.

Kassabian A, Stein J, Jabbour N, Parsa K, Skinner D, D P, et al. Renal cell carcinoma metastatic to the pancreas: a single-institution series and review of the literature. Urology. 2000;56(2). https://doi.org/10.1016/s0090-4295(00)00639-7.

Bassi C, Butturini G, Falconi M, Sargenti M, Mantovani W, Pederzoli P. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma. The British journal of surgery. 2003;90(5). https://doi.org/10.1002/bjs.4072.

Miura T, Nakamura N, Ogawa K, Watanabe Y, Yonekura K, T S, et al. [Resection of Pancreatic Metastasis from Renal Cell Carcinoma 21 Years after Nephrectomy]. Gan to kagaku ryoho. Cancer & chemotherapy. 2016;43(12). https://pubmed.ncbi.nlm.nih.gov/28133264/

Kato D, Abe Y, Nishihara K, Katsumoto F, Tamae K, Mitsuyama S. Pancreatic metastasis from renal cell carcinoma 13 years after a nephrectomy: report of a case. International surgery. 2007;92(4). https://pubmed.ncbi.nlm.nih.gov/18050834/

Faure Jp, Tuech Jj, Richer Jp, Pessaux P, Arnaud Jp, Carretier M. Pancreatic metastasis of renal cell carcinoma: presentation, treatment and survival. The Journal of urology. 2001;165(1). https://doi.org/10.1097/00005392-200101000-00005

Hirota T, Tomida T, Iwasa M, Takahashi K, Kaneda M, Tamaki H. Solitary pancreatic metastasis occurring eight years after nephrectomy for renal cell carcinoma. A case report and surgical review. International journal of pancreatology : official journal of the International Association of Pancreatology. 1996;19(2). https://doi.org/10.1007/BF02805229.

Thompson Ld, Heffess Cs. Renal cell carcinoma to the pancreas in surgical pathology material. Cancer. 2000;89(5). https://doi.org/10.1002/1097-0142(20000901)89:5<1076::aid-cncr17>3.0.co;2-m.

Vilar Tabanera A, Muñoz Muñoz P, Molina Villar JM, Gajate P, Sanjuanbenito A. Surgery of pancreatic metastasis from renal cell carcinoma. Cirugia Espanola. 2022;100(1): 50–52. https://doi.org/10.1016/j.cireng.2021.11.005.

Grassi P, Doucet L, Giglione P, Grünwald V, Melichar B, Galli L, et al. Clinical Impact of Pancreatic Metastases from Renal Cell Carcinoma: A Multicenter Retrospective Analysis. PLoS ONE. 2016;11(4): e0151662. https://doi.org/10.1371/journal.pone.0151662.

Showalter SL, Hager E, Yeo CJ. Metastatic disease to the pancreas and spleen. Seminars in Oncology. 2008;35(2): 160–171. https://doi.org/10.1053/j.seminoncol.2007.12.008.

Sperti C, Moletta L, Patanè G. Metastatic tumors to the pancreas: The role of surgery. World journal of gastrointestinal oncology. 2014;6(10). https://doi.org/10.4251/wjgo.v6.i10.381.

Sellner F. Isolated pancreatic metastases from renal cell carcinoma: an outcome of a special metastatic pathway or of specific tumor cell selection? Clinical & experimental metastasis. 2018;35(3). https://doi.org/10.1007/s10585-018-9910-1.

Cheng SKH, Chuah KL. Metastatic Renal Cell Carcinoma to the Pancreas: A Review. Archives of Pathology & Laboratory Medicine. 2016;140(6): 598–602. https://doi.org/10.5858/arpa.2015-0135-RS.

Schwarz L, Sauvanet A, Regenet N, Mabrut JY, Gigot JF, Housseau E, et al. Long-term survival after pancreatic resection for renal cell carcinoma metastasis. Annals of Surgical Oncology. 2014;21(12): 4007–4013. https://doi.org/10.1245/s10434-014-3821-4.

Mikhail M, Chua KJ, Khizir L, Tabakin A, Singer EA. Role of metastasectomy in the management of renal cell carcinoma. Frontiers in Surgery. 2022;9: 943604. https://doi.org/10.3389/fsurg.2022.943604.

Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear cell renal carcinoma to the pancreas: an indication for pancreatic surgery. Annals of surgical oncology. 2006;13(1). https://doi.org/10.1245/ASO.2006.03.064.

Tanis Pj, van der Gaag Na, Busch Or, van Gulik Tm, Gouma Dj. Systematic review of pancreatic surgery for metastatic renal cell carcinoma. The British journal of surgery. 2009;96(6). https://doi.org/10.1002/bjs.6606.

Boni A, Cochetti G, Ascani S, Del Zingaro M, Quadrini F, Paladini A, et al. Robotic treatment of oligometastatic kidney tumor with synchronous pancreatic metastasis: case report and review of the literature. BMC Surgery. 2018;18: 40. https://doi.org/10.1186/s12893-018-0371-x.

Jo S, Yang IJ, Song S. Surgery for metastatic renal cell carcinoma in the pancreatic head: A case report and literature review. Annals of Hepato-Biliary-Pancreatic Surgery. 2019;23(1): 91. https://doi.org/10.14701/ahbps.2019.23.1.91.

Published

2024-10-06

Issue

Section

Original articles