Pancreatic metastasis from renal cell carcinoma: Which patients benefit from surgical resection?
Pancreatic metastasis from renal cell carcinoma: Which patients benefit from surgical resection?
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DOI：
10.1245/s10434-007-9782-0
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发表时间：
2008-04-01
影响因子：
3.7
通讯作者：
Di Carlo, Valerio
中科院分区：
文献类型：
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作者：
Zerbi, Alessandro;Ortolano, Enrico;Di Carlo, Valerio
背景：胰腺是肾细胞癌（RCC）转移的可能部位。本研究的目的是确定手术在其treatment.Methods的作用：我们回顾性分析了36例胰腺癌转移患者观察1998年1月至2006年2月。根据改良的纪念斯隆-凯特琳预后因素模型，将患者分为三个风险组。结果：23例患者接受了切除手术，其中：远端胰腺切除术11例，摘除术5例，胰十二指肠切除术4例，全胰腺切除术2例，中段胰腺切除术1例。未观察到围手术期死亡;发病率为47.8%。所有接受切除术的患者均属于有利风险组。13例病例因局部晚期疾病（2例）或胰腺外疾病（11例）而排除手术切除;其中5例患者的风险为有利，7例为中度，1例为不良风险。在接受手术的患者中，5年精算生存率为88%，中位无病生存期为44个月。未接受手术的患者5年生存率为47%，中位生存时间为27个月（P = 0.02）。结论：即使存在其他转移部位或多灶性胰腺疾病，属于有利风险组的RCC胰腺转移患者也是切除的候选者。
Background: Pancreas is a possible site of metastases from renal cell carcinoma (RCC). The aim of this study was to define the role of surgery in their treatment.Methods: We retrospectively analyzed 36 patients with pancreatic metastasis from RCC observed between January 1998 and February 2006. Patients were categorized into three risk groups according to the modified Memorial Sloan-Kettering prognostic factors model.Results: Resective surgery was performed in 23 patients, as follows: 11 distal pancreatectomy, 5 enucleation, 4 pancreatoduodenectomy, 2 total pancreatectomy, and 1 middle pancreatectomy. No perioperative mortality was observed; the morbidity rate was 47.8%. All patients who underwent resection belonged to the favorable risk group. Surgical resection was excluded in 13 cases because of locally advanced disease (2 cases) or extrapancreatic disease (11 cases); 5 of these patients were at favorable, 7 at intermediate, and 1 at poor risk. In patients undergoing surgery, the 5-year actuarial survival rate was 88%, and median disease-free survival was 44 months. Patients who did not undergo surgery had a 5-year survival rate of 47%, with a median survival time of 27 months (P = .02).Conclusions: Patients with pancreatic metastases from RCC belonging to a favorable risk group are candidates for resection, even in the presence of another metastatic site or multifocal pancreatic disease.