Pancreatic metastases after surgery for renal cell carcinoma: survival and pathways of progression

Cignoli, Daniele; Fallara, Giuseppe; Ambrosi, Francesca; Larcher, Alessandro; Rosiello, Giuseppe; Rowe, Isaline; Basile, Giuseppe; Colandrea, Gianmarco; Martini, Alberto; Cobelli, Francesco De; Brembilla, Giorgio; Lucianò, Roberta; Colecchia, Maurizio; Lena, Marco Schiavo; Partelli, Stefano; Tamburrino, Domenico; Zamboni, Giuseppe; Rubini, Corrado; Falconi, Massimo; Montorsi, Francesco; Salonia, Andrea; Capitanio, Umberto

doi:10.1007/s00345-022-04106-z

Cited by 7 publications

(7 citation statements)

References 26 publications

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“…RCC is characterized by a broad metastatic spectrum, but among metastatic involvement of organs, the pancreas seems to be a frequent site [ 6 ]. The pancreatic tropism of metastatic RCC is defined by a particularly favorable outcome and seems to be associated with the indolent behavior of the primary tumor, compared with RCC metastasizing to other sites [ 6 , 7 ]. This has enabled authors to conclude that the presence of PM in the setting of RCC is an indicator of a disease course with good prognosis [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

et al. 2023

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Metastasis to the pancreas represents a small proportion of all pancreatic malignancies. Among primary tumors that metastasize to the pancreas, renal cell carcinoma (RCC) is one of the most common causes of metastatic pancreatic lesions. We herein report a case series of three patients with pancreatic metastasis from RCC. The first is a 54-year-old male with a history of left nephrectomy for RCC, in whom an isthmic pancreatic mass suggestive of a neuroendocrine lesion was found during oncological follow-up. Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) identified pancreatic metastasis of RCC and the patient was referred for surgery. The second case is a 61-year-old male, hypertensive, diabetic, with left nephrectomy for RCC six years previously, who complained of weight loss and was found with a hyperenhancing mass in the head of the pancreas and a lesion with a similar pattern in the gallbladder. EUS-FNB from the pancreas proved to be a metastatic pancreatic lesion. Cholecystectomy and treatment with tyrosine kinase inhibitors were recommended. The third case is a 68-year-old dialysis patient referred for evaluation of a pancreatic mass, also confirmed by EUS-FNB, who was started on sunitinib treatment. We report a literature summary on epidemiology and clinical features, diagnosis and differential diagnosis and treatment and outcomes in pancreatic metastasis of RCC.

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Section: Discussionmentioning

confidence: 99%

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

et al. 2023

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“…Con alrededor de una docena de variantes histológicas reconocidas de tumores de células renales, las más comunes son el de células claras, el papilar y el cromófobo, que representan el 75 %-85 %, 10 %-15 % y 5 %-10 %, respectivamente, caracterizándose por presentar diferencias genéticas, moleculares, patológicas y clínicas (Choueiri & Motzer, 2017;Dudani et al, 2021). De tal modo que estas diferencias relacionadas con la biología tumoral, se asocian también a sitios de afectación metastásica; de hecho, existe evidencia respecto a que pacientes con CCR que desarrollaron MP, pueden tener resultados clínicos extraordinarios, debido a una biología subyacente favorable a diferencia de las metástasis hepáticas, óseas y cerebrales, que se asocian con mal pronóstico (Grassi et al, 2016;Cignoli et al, 2022). Encontramos 4 RS relacionadas, todas ellas de estudios retrospectivos, por lo que aportan un nivel de evi-dencia 3a para estudios de tratamiento (Jaen-Torrejimeno et al, 2020;Rodger et al, 2022;Sellner et al, 2023;Brozzetti et al, 2023).…”

Section: Discussionunclassified

“…De hecho, se estima que la mitad de todas las MP son causados por el CCR (Li et al, 2019). Sin embargo, en contraste con el pronóstico sombrío de las enfermedades metastásicas en general, el CCR metastásico al páncreas tiene un resultado favorable (Cignoli et al, 2022;Balaban et al, 2023).…”

Section: Introductionunclassified

Metástasis Pancreática Metacrónica de un Carcinoma de Células Renales. Reporte de un Caso

Manterola,

Rivadeneira,

Salgado

et al. 2023

Int. J. Morphol.

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RESUMEN:El carcinoma de células renales (CCR) a nivel mundial presenta una incidencia de 431.288 casos anuales, causando 179.368 muertes en 2020. Sin embargo, a pesar de su incidencia, el desarrollo de metástasis pancreática (MP) de un RCC es un hecho inusual. El objetivo de este manuscrito fue reportar el caso de una paciente con una MP metacrónica de un CCR. Se trata de una paciente de 56 años, sexo femenino, nefrectomizada derecha hace 132 meses por un CCR, en adyuvancia con inmunoterapia. En un control imagenológico de rutina, se le pesquisó una lesión de aspecto tumoral en el cuerpo y cola del páncreas. Se intervino quirúrgicamente, realizándose una pancreatectomía córporo-caudal con preservación esplénica. Evolucionó de forma satisfactoria, sin complicaciones, siendo dada de alta al 4º día de su cirugía. El informe del estudio de la pieza operatoria con estudio inmunohistoquímico concluyó que se trataba de una MP de CCR. La paciente se encuentra en buenas condiciones generales y re-inició quimioterapia con anticuerpos monoclonales. El seguimiento frecuente y prolongado de pacientes con antecedentes de CCR, facilita un diagnóstico y tratamiento oportuno de MP facilitando el mejor pronóstico de los pacientes, con tasas más altas de supervivencia.

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“…This overall favourable outcome cannot be explained by the single organ involvement per se, but is a specific feature of the isPMRCC, as evidenced by the significantly worse outcome of single organ metastases of the ccRCC in other organs. In a recent study on the impact of single organ metastases on the course of ccRCC, the median survival time of isPMRCC was three times longer than that of single organ metastases in other organs (8.8 vs. 2.8 years; p < 0.001) [45].…”

Section: Introductionmentioning

confidence: 93%

“…Numerous studies have so far dealt with this disease, partly in the form of case studies, or in the form of institutional experience reports, of which 1470 observations were reported by 2022 [1], to which 259 isPMRCC have since been added [2,3,[45][46][47][48][49][50][51][52][53][54][55][56], bringing the total number to 1729.…”

Section: Introductionmentioning

confidence: 99%

Genetic and Epigenetic Characteristics in Isolated Pancreatic Metastases of Clear-Cell Renal Cell Carcinoma

Sellner,

Compérat,

Klimpfinger

2023

IJMS

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Isolated pancreatic metastases of renal cell carcinoma (IsPMRCC) are a rare manifestation of metastatic, clear-cell renal cell carcinoma (RCC) in which distant metastases occur exclusively in the pancreas. In addition to the main symptom of the isolated occurrence of pancreatic metastases, the entity surprises with additional clinical peculiarities: (a) the unusually long interval of about 9 years between the primary RCC and the onset of pancreatic metastases; (b) multiple pancreatic metastases occurring in 36% of cases; (c) favourable treatment outcomes with a 75% 5-year survival rate; and (d) volume and growth-rate dependent risk factors generally accepted to be relevant for overall survival in metastatic surgery are insignificant in isPMRCC. The genetic and epigenetic causes of exclusive pancreatic involvement have not yet been investigated and are currently unknown. Conversely, according to the few available data in the literature, the following genetic and epigenetic peculiarities can already be identified as the cause of the protracted course: 1. high genetic stability of the tumour cell clones in both the primary tumour and the pancreatic metastases; 2. a low frequency of copy number variants associated with aggressiveness, such as 9p, 14q and 4q loss; 3. in the chromatin-modifying genes, a decreased rate of PAB1 (3%) and an increased rate of PBRM1 (77%) defects are seen, a profile associated with a favourable course; 4. an increased incidence of KDM5C mutations, which, in common with increased PBRM1 alterations, is also associated with a favourable outcome; and 5. angiogenetic biomarkers are increased in tumour tissue, while inflammatory biomarkers are decreased, which explains the good response to TKI therapy and lack of sensitivity to IT.

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Pancreatic metastases after surgery for renal cell carcinoma: survival and pathways of progression

Cited by 7 publications

References 26 publications

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

Metástasis Pancreática Metacrónica de un Carcinoma de Células Renales. Reporte de un Caso

Genetic and Epigenetic Characteristics in Isolated Pancreatic Metastases of Clear-Cell Renal Cell Carcinoma

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