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[转移性肾细胞癌的胰腺切除术]

[Pancreatic resection for metastatic renal cell carcinoma].

作者信息

Varga M, Oliverius M, Valsamis A, Kucera M, Gürlich R, Safanda M, Matia I, Honsová E

机构信息

Klinika transplantacní chirurgie, Institut klinické a experimentální medicíny, Praha.

出版信息

Klin Onkol. 2009;22(6):288-90.

Abstract

BACKGROUNDS

Late metastases of renal cell carcinoma (RCC) are quite common. However, metastases in the pancreas are rare. Between 2004-2008 the Department of transplantation surgery of the institute of clinical and experimental medicine performed 87 pancreatic resections for tumour. From this, metastasis of RCC was histologically verified in four cases.The aim of this study was to summarize in the form of brief case reports our experience with the surgical treatment of pancreatic metastasis of RCC.

OBSERVATION

The interval from nephrectomy to the occurrence of pancreatic metastasis was 10, 11, 15 and 16 years. All patients were examined to exclude metastatic generalization. Surgical treatment was: one total pancreatectomy, two subtotal pancreatectomies and one caudal resection. Two patients had solitary pancreatic metastasis, one had two metastases and one had multiple metastatic lesions. No complications were observed in the postoperative period. All patients are living with survival time of 7, 23, 26 and 52 months. None of them has signs of recurrence of the primary disease.

CONCLUSION

The follow up in patients with a history of RCC should be lifelong. Considering the low response of RCC and its metastases to oncological treatment, pancreatic resection is a safe method with a low rate of complications in patients with RCC metastases limited only to the pancreas and detected in time.

摘要

背景

肾细胞癌(RCC)的晚期转移相当常见。然而,胰腺转移却很罕见。2004年至2008年间,临床与实验医学研究所移植外科为肿瘤患者实施了87例胰腺切除术。其中,有4例经组织学证实为RCC转移。本研究的目的是以简短病例报告的形式总结我们对RCC胰腺转移外科治疗的经验。

观察

从肾切除到发生胰腺转移的间隔时间分别为10年、11年、15年和16年。所有患者均接受检查以排除转移扩散。手术治疗方式为:1例全胰切除术、2例次全胰切除术和1例胰尾切除术。2例患者为孤立性胰腺转移,1例有2处转移,1例有多处转移病灶。术后未观察到并发症。所有患者均存活,生存时间分别为7个月、23个月、26个月和52个月。他们均无原发疾病复发迹象。

结论

有RCC病史的患者应进行终身随访。鉴于RCC及其转移灶对肿瘤治疗的反应较低,对于仅局限于胰腺且及时发现的RCC转移患者,胰腺切除术是一种安全且并发症发生率低的方法。

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