High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma

Bassi, Claudio; Butturini, Giovanni; Falconi, Massimo; Sargenti, Manuela; Mantovani, William; Pederzoli, Paolo

doi:10.1002/bjs.4072

Cited by 143 publications

(135 citation statements)

References 17 publications

(23 reference statements)

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“…Bassi et al found a higher rate of morbidity and local recurrence after atypical resections, and consequently advised standard resections for all pancreatic metastases [6]. However, other authors did not find any statistically significant difference in outcomes when comparing standard versus atypical resections [12,21,23] .…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 4 featured patient populations that overlapped with subsequent, larger studies, and 12 were rejected because they did not fulfil the inclusion criteria. The remaining 18 studies met the above criteria to merit inclusion in the extractable and analysable dataset [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. The search strategy and outcomes are summarised in Figure 1.…”

Section: Search Yields and Data Retrievalmentioning

confidence: 99%

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Pancreatectomy for metastatic disease: A systematic review

Adler

Redmond

Heneghan

et al. 2014

European Journal of Surgical Oncology (EJSO)

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Aim: Tumours rarely metastasise to the pancreas. While surgical resection of such metastases is believed to confer a survival benefit, there is limited data to support such management. We present a systematic review of case series of pancreatic metastasectomy and analysis of survival outcomes.Methods: A literature search was performed using the PubMed and Cochrane databases and the reference lists of relevant articles, searching for sizeable case series of pancreatic metastasectomy with curative intent. Data extracted included basic demographics, histological primary tumour, presentation, operative management, complications and survival, while the MINORS index was used to assess study quality.Results: 18 studies were found which met our inclusion criteria, involving 399 patients. Renal cell carcinoma (RCC) was the commonest malignancy metastasising to the pancreas, responsible for 62.6% of cases, followed by sarcoma (7.2%) and colorectal carcinoma (6.2%). While survival data was not uniformly reported, the median survival post-metastasectomy was 50.2 months, with a oneyear survival of 86.81% and five-year survival of 50.02%. Median survival for RCC was 71.7 months with 70.4% five-year survival. Median survival was similar in patients with synchronous and metachronous pancreatic metastases, but patients with additional extrapancreatic metastases had a significantly shorter survival than patients with isolated pancreatic metastases (26 versus 45 months). Study quality was poor, with a median MINORS score of 10/16. Conclusions:Within the limitations of a review of non-randomised case series, it would appear that pancreatic metastasectomy confers a survival benefit in selected patients. Better evidence is required, but may prove difficult to acquire. Key words:pancreatic metastasis, metastasectomy, pancreatectomy, metastatic renal cell cancer, 3 Introduction:

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Section: Discussionmentioning

confidence: 99%

Section: Search Yields and Data Retrievalmentioning

confidence: 99%

Pancreatectomy for metastatic disease: A systematic review

Adler

Redmond

Heneghan

et al. 2014

European Journal of Surgical Oncology (EJSO)

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“…In patients with pancreatic metastases from RCC, absence of extrapancreatic metastases and limited vascular involvement, 2 and 5 years survival rates of 78% and 65%, respectively after resection of pancreatic disease are reported [3,4]. In our patients, radical nephrectomy and distal pancreatectomy were performed without complications.…”

Section: Discussionmentioning

confidence: 68%

“…Their incidence in autopsy series has been reported as 1-3% in patients with primary RCC and their diagnosis is often radiological [1]. Early detection of RCC pancreatic metastases, frequently performed by multidetector computed tomography (MDCT) dut to the imaging pattern of hyperenhancing lesions allows for appropriate treatment and improved outcomes for metastatic disease [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Unusual imaging of pancreatic metastasis: A case report of tumor-to-tumor metastasis

Graziani¹,

Scocco²,

Carrara³

et al. 2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Metastasis of one tumor to another tumor is a very rare and controversial phenomenon. Solitary renal cell carcinoma metastasis to a preexisting pancreatic endocrine tumor is distinctly uncommon. We report atypical imaging findings of pancreatic metastasis from renal cell carcinoma, due to tumor-to-tumor metastasis for presence of renal cell carcinoma metastasizing to a pancreatic endocrine tumor. Case Report: A 78-year-old male suffering from mild anemia underwent to multidetector computed tomography scan showing renal cell carcinoma and solid-cystic pancreatic mass, both resectable, treated with right radical nephrectomy and spleno-distal pancreatectomy.Histopathology of the resected renal and pancreatic specimens confirmed a clear cells right renal cell carcinoma metastatic to endocrine neoplasm of pancreatic body-tail. We compared multidetector computed tomography scan findings and histopathological pancreatic specimen. The imaging finding of peripheral rim enhancement coincided in pancreatic pathologic specimen with presence of pancreatic endocrine tumor. The imaging finding of solid trabeculae inside the mass corresponded in pancreatic pathologic specimen to presence of pancreatic endocrine tumor mixed with lobules of typical renal carcinoma metastatic cells. Finally, the imaging finding of hypoenhancing central area of lesion coincided in pancreatic pathologic specimen with presence of large necrotic component. Conclusion:We describe an unusual multidetector computed tomography scan finding of renal cell carcinoma metastasizing to pancreatic endocrine tumor and emphasize the knowledge of rare phenomena of tumor-to-tumor metastasis.

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“…In patients with RCC, up to 30% have metastases at presentation, and 40À50% will develop widespread metastatic disease over time (3). The long-term (5-year) survival rate is 10À15% once metastases have spread (1).…”

Section: Introductionmentioning

confidence: 99%

Autologous Islet Transplantation After Total Pancreatectomy for Renal Cell Carcinoma Metastases

Gala-López

Semlacher

Manouchehri

et al. 2013

American Journal of Transplantation

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High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma

Abstract: Despite the slow development of these secondaries and their well encapsulated morphology, the high rate of recurrence after limited resection suggests that radical resection should be recommended.

Cited by 143 publications

References 17 publications

Pancreatectomy for metastatic disease: A systematic review

Pancreatectomy for metastatic disease: A systematic review

Unusual imaging of pancreatic metastasis: A case report of tumor-to-tumor metastasis

Autologous Islet Transplantation After Total Pancreatectomy for Renal Cell Carcinoma Metastases

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