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[透明细胞肾细胞癌胰腺转移的临床病理特征及预后分析]

[The clinicopathologic features and prognostic analysis of pancreatic metastasis from clear cell renal cell carcinoma].

作者信息

Zhang Z Y, Li X Y, Bai C M, Zhou Y, Wu X, Yang A M, Hua S R

机构信息

Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2020 Jan 23;42(1):44-49. doi: 10.3760/cma.j.issn.0253-3766.2020.01.006.

Abstract

To investigate the clinicopathologic features and prognosis of the patients who had clear cell renal cell carcinoma (CCRCC) with metastasis to the pancreas. From Jan, 2000 to Dec, 2018, 18 patients with clear cell renal cell carcinoma (CCRCC) and had pathologically diagnosed metastasis to the pancreas were enrolled at Peking Union Medical College Hospital. The clinical and pathological data were retrospectively analyzed. 11 out of 18 patients were male, and the other 7 were female. The average age of onset of CCRCC was 51.4 years. 8 cases (44.4%) occurred in the left kidney, and the other 10 cases (55.6%) with right kidney tumor. Three patients had synchronous pancreatic metastasis, and the other 15 patients had metachronous pancreatic metastasis. The median time from CCRCC onset to pancreas metastasis was 156 months. The main complaints of pancreas metastasis were abdominal pain, jaundice, gastrointestinal bleeding, nausea, weakness, loss of weight and so on. Seven patients (38.9%) had single lesion of pancreas, while 11 patients (66.1%) had multiple lesions of pancreas. Nine patients (50%) had other organs metastasis besides pancreatic metastasis at the same time. Five patients underwent pancreatic metastasis resection, while 15 patients received oral tyrosine kinase inhibitor(TKI). The mean follow-up was 171.7 months(1~361.5 months) and 5 patients died. The median overall survival (mOS) was 122 months, and the 5 year-survival rate was 81.4%. In univariate analysis, synchronous metastasis to the pancreas, relapse after 10 years, Memorial Sloan Kettering Cancer Center prognostic index, International Metastatic Renal Cell Carcinoma Database Consortium index were all significant parameters for patients'survival. Metastasis to the pancreas from clear cell renal cell carcinoma were rare. These patients had better survival outcomes, especially those relapsing after ten years. Pancreatic metastasis resection had no significant benefit on patient's survival.

摘要

探讨发生胰腺转移的透明细胞肾细胞癌(CCRCC)患者的临床病理特征及预后。2000年1月至2018年12月,北京协和医院收治18例经病理诊断为胰腺转移的透明细胞肾细胞癌患者。对其临床及病理资料进行回顾性分析。18例患者中男性11例,女性7例。CCRCC的平均发病年龄为51.4岁。8例(44.4%)发生于左肾,另10例(55.6%)为右肾肿瘤。3例患者为同时性胰腺转移,另15例为异时性胰腺转移。从CCRCC发病至胰腺转移的中位时间为156个月。胰腺转移的主要症状为腹痛、黄疸、胃肠道出血、恶心、乏力、体重减轻等。7例(38.9%)患者胰腺为单发病灶,11例(66.1%)为多发病灶。9例(50%)患者同时合并胰腺转移外的其他器官转移。5例患者接受了胰腺转移灶切除术,15例患者接受口服酪氨酸激酶抑制剂(TKI)治疗。平均随访时间为171.7个月(1~361.5个月),5例患者死亡。中位总生存期(mOS)为122个月,5年生存率为81.4%。单因素分析显示同时性胰腺转移、10年后复发、纪念斯隆凯特琳癌症中心预后指数、国际转移性肾细胞癌数据库联盟指数均为影响患者生存的显著参数。透明细胞肾细胞癌胰腺转移少见。这些患者生存结局较好,尤其是10年后复发者。胰腺转移灶切除术对患者生存无显著益处。

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