Pancreatic resection for metastasis from renal cell carcinoma: A single institution experience and meta-analysis of survival outcomes

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 24; no. 1; pp. 160 - 168
• Main Authors: Hajibandeh, Shahin, Hajibandeh, Shahab, Romman, Saleh, Ghassemi, Nader, Evans, Daisy, Laing, Richard W, Durkin, Damien, Athwal, Tejinderjit S
• Format: Journal Article
• Language: English
• Published: Switzerland 01.02.2024
• Subjects: Acute Disease; Aged; Carcinoma, Renal Cell - pathology; Female; Humans; Kidney Neoplasms - pathology; Male; Middle Aged; Pancreatectomy; Pancreatic Neoplasms - secondary; Pancreatic Neoplasms - surgery; Pancreatitis - etiology; Retrospective Studies; Treatment Outcome; Renal cell carcinoma; Survival; Pancreatic resection
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2023.11.014

To evaluate short-term clinical and long-term survival outcomes of pancreatic resection for pancreatic metastasis from renal cell carcinoma (RCC). A retrospective evaluation of patients undergoing pancreatic resection for metastasis from RCC over a 12-years period was conducted. Furthermore, a systematic search of electronic data sources and bibliographic reference lists were conducted to identify studies investigating the same clinical question. Short-term clinical and long-term survival outcomes were evaluated. Kaplan-Meier survival plots were constructed for survival outcomes. Cox-proportional regression analysis was performed to determine factors associated with survival. Finally, meta-analysis of survival outcomes was conducted using random-effects modelling. Eighteen patients underwent pancreatic resections for RCC pancreatic metastasis within the study period. The mean age of the included patients was 63.8 ± 8.0 years. There were 10(55.6 %) male and 8(44.4 %) female patients. Pancreatectomy was associated with 4(25.0 %) Clavien-Dindo (C-D) I, 5(31.3 %) C-D II, and 7(43.7 %) C-D III complications, 7(38.8 %) pancreatic fistula, 3(16.7 %) post-pancreatectomy acute pancreatitis, 1(5.6 %) delayed gastric emptying, and 1(5.6 %) chyle leak. The mean length of hospital stay was 18 ± 16.3 days. The median survival was 64 months (95 % CI 60-78). The 3-and 5-year disease-free survival rates were 83.3 % and 55.5 %, respectively. The 3-and 5-year survival rates were 100 % and 55.6 %, respectively. The pooled analyses of 553 patients demonstrated 3-and 5-year survival rates of 77.6 % and 60.7 %, respectively. Pancreatectomy for RCC metastasis is associated with acceptable short-term clinical and promising long-term survival outcomes. Considering the rarity of the entity, escalation of level of evidence in this context is challenging.