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Results of surgical management of renal cell carcinoma metastatic to the pancreas.

Kusnierz K, Mrowiec S, Lampe P - Contemp Oncol (Pozn) (2014)

Bottom Line: Operative mortality was 0%.In our group of 7 deceased patients the mean survival was 19 months (median 16 months).In our series a large number of patients with occurrence of symptoms, advancement of tumours, metastases to lymph node, and positive margin were connected with short survival period.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland.

ABSTRACT

Aim of the study: Metastases from renal cell carcinoma represent between 0.25% and 3.00% of all resected pancreatic tumours. The aim of this study was to review 13 patients with renal cell carcinoma metastatic to the pancreas.

Material and methods: Clinical data, time from initial presentation, operative outcome, long-term survival, tumour size, presence of lymphatic invasion, and surgical margin status were evaluated.

Results: The median age of the patients was 62 years (mean 60.9). The median time for appearance of metastatic disease following resection of the primary tumour was 9 years (mean 8.38). Pancreatic metastases were located in the head of the pancreas in four patients, in the body in three, in the tail in two patients, and four patients had multiple pancreatic localisations. Four (30.7%) pancreatoduodenectomies, 5 (38.5%) distal resections, 2 (15.3%) total pancreatectomies, 1 (7.6%) enucleation, and 1 (7.6%) Roux duodenojejunostomy were performed. Two patients (15.3%) had postoperative complications. Operative mortality was 0%. Surgical margins were microscopically positive in 1 (8.3%) patient, and lymph nodes were positive in 2 (16.6%) patients. In our group of 7 deceased patients the mean survival was 19 months (median 16 months).

Conclusions: Renal cell carcinoma metastatic to the pancreas can occur several years after nephrectomy. In our series a large number of patients with occurrence of symptoms, advancement of tumours, metastases to lymph node, and positive margin were connected with short survival period. Early detection of primary tumour, long and thorough patient care, and radical resections give patients a chance for a prolonged life.

No MeSH data available.


Related in: MedlinePlus

Surgical specimen of the distal pancreatectomy with metastatic renal cell carcinoma
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Figure 0002: Surgical specimen of the distal pancreatectomy with metastatic renal cell carcinoma

Mentions: Pancreatic metastases were located in the head of the pancreas in 4 patients (30.7%), in the body in 3 (23%), in the tail in 2 (15.3%), and 4 patients (30.7%) had multiple pancreatic localisations. A total pancreatectomy was performed in 2 (15.3%) patients for multiple pancreatic metastases, 1 with splenectomy. Four (30.7%) pancreatoduodenectomies, 2 of them as Whipple, 1 as Claget, and 1 as a pylorus preserving pancreatoduodenectomy, were performed for metastasis in the pancreatic head. For metastases in the pancreatic body and the tail, 5 (38.5%) distal resections were performed (Fig. 2), 2 with splenectomy. Furthermore, we performed 1 (7.6%) enucleation for metastasis in the body of the pancreas, together with a liver resection for simultaneous pancreatic and liver metastasis. In 1 (7.6%) patient, resection was not performed because of locally advanced disease, and only Roux duodenojejunostomy was carried out. Twelve patients in our series underwent an elective surgical procedure, andone patient required urgent pancreatoduodenectomy. In the urgent case, this resulted from tumour erosion through the wall of the duodenum, leading to upper gastrointestinal bleeding.


Results of surgical management of renal cell carcinoma metastatic to the pancreas.

Kusnierz K, Mrowiec S, Lampe P - Contemp Oncol (Pozn) (2014)

Surgical specimen of the distal pancreatectomy with metastatic renal cell carcinoma
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507895&req=5

Figure 0002: Surgical specimen of the distal pancreatectomy with metastatic renal cell carcinoma
Mentions: Pancreatic metastases were located in the head of the pancreas in 4 patients (30.7%), in the body in 3 (23%), in the tail in 2 (15.3%), and 4 patients (30.7%) had multiple pancreatic localisations. A total pancreatectomy was performed in 2 (15.3%) patients for multiple pancreatic metastases, 1 with splenectomy. Four (30.7%) pancreatoduodenectomies, 2 of them as Whipple, 1 as Claget, and 1 as a pylorus preserving pancreatoduodenectomy, were performed for metastasis in the pancreatic head. For metastases in the pancreatic body and the tail, 5 (38.5%) distal resections were performed (Fig. 2), 2 with splenectomy. Furthermore, we performed 1 (7.6%) enucleation for metastasis in the body of the pancreas, together with a liver resection for simultaneous pancreatic and liver metastasis. In 1 (7.6%) patient, resection was not performed because of locally advanced disease, and only Roux duodenojejunostomy was carried out. Twelve patients in our series underwent an elective surgical procedure, andone patient required urgent pancreatoduodenectomy. In the urgent case, this resulted from tumour erosion through the wall of the duodenum, leading to upper gastrointestinal bleeding.

Bottom Line: Operative mortality was 0%.In our group of 7 deceased patients the mean survival was 19 months (median 16 months).In our series a large number of patients with occurrence of symptoms, advancement of tumours, metastases to lymph node, and positive margin were connected with short survival period.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice, Poland.

ABSTRACT

Aim of the study: Metastases from renal cell carcinoma represent between 0.25% and 3.00% of all resected pancreatic tumours. The aim of this study was to review 13 patients with renal cell carcinoma metastatic to the pancreas.

Material and methods: Clinical data, time from initial presentation, operative outcome, long-term survival, tumour size, presence of lymphatic invasion, and surgical margin status were evaluated.

Results: The median age of the patients was 62 years (mean 60.9). The median time for appearance of metastatic disease following resection of the primary tumour was 9 years (mean 8.38). Pancreatic metastases were located in the head of the pancreas in four patients, in the body in three, in the tail in two patients, and four patients had multiple pancreatic localisations. Four (30.7%) pancreatoduodenectomies, 5 (38.5%) distal resections, 2 (15.3%) total pancreatectomies, 1 (7.6%) enucleation, and 1 (7.6%) Roux duodenojejunostomy were performed. Two patients (15.3%) had postoperative complications. Operative mortality was 0%. Surgical margins were microscopically positive in 1 (8.3%) patient, and lymph nodes were positive in 2 (16.6%) patients. In our group of 7 deceased patients the mean survival was 19 months (median 16 months).

Conclusions: Renal cell carcinoma metastatic to the pancreas can occur several years after nephrectomy. In our series a large number of patients with occurrence of symptoms, advancement of tumours, metastases to lymph node, and positive margin were connected with short survival period. Early detection of primary tumour, long and thorough patient care, and radical resections give patients a chance for a prolonged life.

No MeSH data available.


Related in: MedlinePlus