Clinical outcome of patients with pancreatic metastases from renal cell cancer.
Clinical outcome of patients with pancreatic metastases from renal cell cancer.
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DOI：
10.1186/s12885-015-1050-2
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发表时间：
2015-02-12
期刊：
影响因子：
3.8
通讯作者：
Yonese J
中科院分区：
文献类型：
--
作者：
Yuasa T;Inoshita N;Saiura A;Yamamoto S;Urakami S;Masuda H;Fujii Y;Fukui I;Ishikawa Y;Yonese J
肾细胞癌（RCC）是转移性胰腺肿瘤最常见的原发部位之一，尽管转移性肿瘤在胰腺恶性肿瘤中很少见。本研究的目的是揭示肾细胞癌胰腺转移的特征和治疗结果。对我院1999 - 2013年收治的262例转移性RCC患者进行回顾性分析，其中20例（7.6%）同时发生或随后获得胰腺转移。从RCC诊断到胰腺转移的中位随访时间分别为13.4年（四分位数范围：IQR， 7.8-15.5年）和3.8年（IQR, 2.1-5.5年）。从诊断为RCC到胰腺转移的中位持续时间为7.8年（IQR, 4.2-12.7年）。在此观察期间，未达到从诊断为RCC到死亡或从胰腺转移到死亡的估计中位总生存（OS）时间。胰腺转移后患者在1年、3年和5年的生存率分别为100,87.7和78.9%。胰腺转移患者从诊断为转移到死亡的估计OS期明显长于非胰腺转移患者（中位OS为2.7年）（P < 0.0001）。手术治疗胰腺转移15例（75%）。当这些手术的中位随访期为3.5年（IQR为1.9-5.2年）时，估计的中位无复发生存期为1.8年。对于多发转移部位的患者，6例（30%）患者接受分子靶向治疗。中位随访期为4.1年（IQR, 3.0-4.4年），未见疾病进展。胰腺通常是唯一的转移部位，转移通常发生在肾切除术后很长一段时间。这些患者的OS期较长，手术和内科治疗均取得了良好的效果。
Renal cell cancer (RCC) is one of the most frequent primary sites for metastatic pancreatic tumors although metastatic tumors are rare among pancreatic malignant tumors. The purpose of this study is to disclose the characterization and treatment outcomes of pancreatic metastases from RCC. Of 262 patients with metastatic RCC treated at our hospital between 1999 and 2013, the data of 20 (7.6%) who simultaneously developed or subsequently acquired pancreatic metastases were retrospectively reviewed and statistically analyzed. The median follow-up period from RCC diagnosis and pancreatic metastases was 13.4 years (inter-quartile range: IQR, 7.8–15.5 years) and 3.8 years (IQR, 2.1–5.5 years), respectively. Median duration from diagnosis of RCC to pancreatic metastasis was 7.8 years (IQR, 4.2–12.7 years). During this observation period, the estimated median overall survival (OS) time from the diagnosis of RCC to death or from pancreatic metastasis to death was not reached. The probability of patients surviving after pancreatic metastasis at 1, 3, and 5 years was 100, 87.7, and 78.9%, respectively. The estimated OS period from the diagnosis of metastases to death of the patients with pancreatic metastasis was significantly longer than that of the patients with non-pancreatic metastasis (median OS 2.7 years) (P < 0.0001). Surgical management for pancreatic metastasis was performed in 15 patients (75%). When the median follow-up period for these surgeries was 3.5 years (IQR, 1.9–5.2 years), the estimated median recurrence-free survival was 1.8 years. For the patients with multiple metastatic sites, molecularly targeted therapies were given to six (30%) patients. When the median follow-up period was 4.1 years (IQR, 3.0–4.4 years), no disease progression was observed. The pancreas is frequently the only metastatic site and metastasis typically occurs a long time after nephrectomy. The OS period of these patients is long and both surgical and medical treatment resulted in good outcomes.
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