Søreide Kjetil, Hauge Elen Martine, Vigmostad Maria Nyre
Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Clin Exp Metastasis. 2025 Jul 3;42(4):38. doi: 10.1007/s10585-025-10359-w.
Metastatic cancer has been considered uniformly fatal in the past with very poor outcomes for most cancer sites. However, novel systemic and targeted therapies have rendered unique responses with longer survival across several cancer types and metastatic sites. In addition, improved surgical experience and safety with good outcomes has made metastasectomy as an alternative curative-intent treatment across multiple organ sites. The pancreas is an uncommon site for metastasis, even if >30 different primary tumor entities have been described to metastasize to the pancreas. More than half of all resected metastasis in the pancreas are from renal cell carcinoma (RCC). RCC demonstrates a particular capacity to metastasize to nearly any site in the body-including uncommon sites like the tongue, salivary glands, spleen, testes, and pancreas-and, have remarkable plasticity and specific molecular trajectories with clinical implications. Cancer cells have a propensity to metastasize to specific organ sites, such as the lungs, liver or skeleton, called "organotropism" and the inherent tumor biology as well as the concept of 'oligometastatic' disease is still controversial and conflicting. Pancreatic metastasis has a very different biology from other RCC metastatic sites. Clinical observations suggest an indolent biology that warrants further investigation. Survival times are very long and approaching up to 10 years in recent series. In this paper we discuss the specific situation of pancreatic metastasis from RCC, the relation to oligometastasis and organotropism and how this can be viewed as a model to better understand cancer biology.
转移性癌症在过去一直被认为是必死无疑的，大多数癌症部位的预后都非常差。然而，新型的全身治疗和靶向治疗在多种癌症类型和转移部位产生了独特的反应，患者生存期延长。此外，手术经验的改善和安全性的提高以及良好的预后，使得转移灶切除术成为多个器官部位一种可选择的根治性治疗方法。胰腺是一个不常见的转移部位，即使已有超过30种不同的原发性肿瘤实体被描述可转移至胰腺。胰腺切除的转移灶中，超过一半来自肾细胞癌（RCC）。RCC显示出特别的转移能力，几乎可转移至身体的任何部位，包括舌、唾液腺、脾脏、睾丸和胰腺等不常见部位，并且具有显著的可塑性和特定的分子轨迹，具有临床意义。癌细胞倾向于转移至特定的器官部位，如肺、肝或骨骼，这被称为“器官趋向性”，而肿瘤的内在生物学特性以及“寡转移”疾病的概念仍存在争议且相互矛盾。胰腺转移与其他RCC转移部位具有非常不同的生物学特性。临床观察表明其生物学特性较为惰性，值得进一步研究。在最近的系列研究中，生存期很长，接近10年。在本文中，我们讨论了RCC胰腺转移的具体情况、与寡转移和器官趋向性的关系，以及如何将其视为一个更好地理解癌症生物学的模型。
