Benhaim Raphael, Oussoultzoglou Elie, Saeedi Yaser, Mouracade Pascal, Bachellier Philippe, Lang Hervé
Department of Urology, Strasbourg University Hospital, Strasbourg, France.
Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Strasbourg University Hospital, Strasbourg, France.
Urology. 2015 Jan;85(1):135-40. doi: 10.1016/j.urology.2014.09.034.
To evaluate the long-term results of patients surgically treated for metastatic clear cell renal cell carcinoma (CCRCC) with a unique pancreatic secondary localization to assess the importance of radical treatment in this rare group of patients.
This is a retrospective monocentric study including 20 surgically treated patients between 1997 and 2012 for a unique pancreatic metastasis of a CCRCC. The main objective was to evaluate the outcome after surgical resection.
Twenty patients were followed up for a CCRCC. The M/F ratio was 1.2. The average age of onset of kidney cancer was 57.05 ± 7.78 years. Two patients who had synchronous pancreatic metastasis and 18 patients who had metachronous metastasis appeared after an average of 130 ± 59 months (24-240 months). The average size of the metastases was 20 ± 11.6 mm. Pancreatic metastasis was unique in all patients, with 35% of patients having multiple lesions of the pancreas. All patients underwent a pancreatic resection of metastasis. Histologic examination confirmed the location of a secondary CCRCC in all patients. Median follow-up after pancreatectomy was 69 months (1-150 months). Disease-free survival at 2 years was 60%. Overall survival rates at 2 and 4 years were 79% and 72%, respectively. There was no difference found between patients with multiple and unique pancreatic metastases in overall survival.
Unique pancreatic metastasis of CCRCC is rare. The literature on this subject is limited. Surgical resection might be an option and can be associated with long-term disease-free intervals in highly selected patients.
评估接受手术治疗的转移性透明细胞肾细胞癌（CCRCC）且胰腺为唯一转移部位的患者的长期预后，以评估根治性治疗在这一罕见患者群体中的重要性。
这是一项回顾性单中心研究，纳入了1997年至2012年间因CCRCC的孤立性胰腺转移而接受手术治疗的20例患者。主要目的是评估手术切除后的预后。
20例患者因CCRCC接受随访。男女比例为1.2。肾癌发病的平均年龄为57.05±7.78岁。2例患者为同时性胰腺转移，18例患者为异时性转移，平均发生时间为130±59个月（24 - 240个月）。转移灶的平均大小为20±11.6毫米。所有患者的胰腺转移均为孤立性，35%的患者胰腺有多个病灶。所有患者均接受了胰腺转移灶切除术。组织学检查证实所有患者均为继发性CCRCC。胰腺切除术后的中位随访时间为69个月（1 - 150个月）。2年无病生存率为60%。2年和4年的总生存率分别为79%和72%。胰腺转移灶为多个和孤立性的患者在总生存率方面无差异。
CCRCC的孤立性胰腺转移罕见。关于该主题的文献有限。手术切除可能是一种选择，在经过严格筛选的患者中可实现长期无病生存期。
