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Pancreatic Resection for Metastatic Renal Cell Carcinoma: Presentation, Treatment, and Outcome

From the Sunnybrook & Women’s College Health Sciences Centre (CHLL, SSH), University of Toronto, Toronto, Ontario, Canada; and University Health Network (ACW, MA-Z, BRT, PDG, BL, SG), University of Toronto, Toronto, Ontario, Canada.

Correspondence: Address correspondence and reprint requests to: Steven Gallinger, MD, Suite 1225, Mount Sinai Hospital, 600 University Ave., Toronto, ON, Canada, M5G 1X5; Fax: 416-586-8392; E-mail: sgallinger{at}mtsinai.on.ca

Background: The diverse natural history of renal cell carcinoma (RCC) includes metastases to the pancreas, a very unusual site for distant spread of other cancers. Considering the relatively indolent behavior of some cases of metastatic RCC, pancreatic resection is offered to select patients.

Methods: We reviewed the records of patients at three affiliated university hospital centers who had prior nephrectomy for RCC and subsequent pancreatic resection of metastases.

Results: Fourteen patients—9 women and 5 men with a median age of 63.8 years—underwent a total of 15 pancreatic resections for metastatic RCC. Nine (64%) had solitary metastases. The median interval from nephrectomy to diagnosis of pancreatic metastases was 83 months. The median size of metastases was 4.6 cm. There was one perioperative death. Pancreatic recurrence occurred in five patients (36%), and one patient underwent repeat resection. At a median follow-up of 32 months, seven patients (50%) are alive without evidence of disease, and four patients (28%) are alive with recurrent disease.

Conclusions: Resection of pancreatic metastases from RCC is associated with long-term survival and should be considered for patients in whom complete resection is possible.

Key Words: Pancreatic neoplasm • Metastasis • Renal cell carcinoma • Pancreatectomy

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