Skip to main content
Top
Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Clinical outcome of patients with pancreatic metastases from renal cell cancer

Authors: Takeshi Yuasa, Naoko Inoshita, Akio Saiura, Shinya Yamamoto, Shinji Urakami, Hitoshi Masuda, Yasuhisa Fujii, Iwao Fukui, Yuichi Ishikawa, Junji Yonese

Published in: BMC Cancer | Issue 1/2015

Login to get access

Abstract

Background

Renal cell cancer (RCC) is one of the most frequent primary sites for metastatic pancreatic tumors although metastatic tumors are rare among pancreatic malignant tumors. The purpose of this study is to disclose the characterization and treatment outcomes of pancreatic metastases from RCC.

Methods

Of 262 patients with metastatic RCC treated at our hospital between 1999 and 2013, the data of 20 (7.6%) who simultaneously developed or subsequently acquired pancreatic metastases were retrospectively reviewed and statistically analyzed.

Results

The median follow-up period from RCC diagnosis and pancreatic metastases was 13.4 years (inter-quartile range: IQR, 7.8–15.5 years) and 3.8 years (IQR, 2.1–5.5 years), respectively. Median duration from diagnosis of RCC to pancreatic metastasis was 7.8 years (IQR, 4.2–12.7 years). During this observation period, the estimated median overall survival (OS) time from the diagnosis of RCC to death or from pancreatic metastasis to death was not reached. The probability of patients surviving after pancreatic metastasis at 1, 3, and 5 years was 100, 87.7, and 78.9%, respectively. The estimated OS period from the diagnosis of metastases to death of the patients with pancreatic metastasis was significantly longer than that of the patients with non-pancreatic metastasis (median OS 2.7 years) (P < 0.0001). Surgical management for pancreatic metastasis was performed in 15 patients (75%). When the median follow-up period for these surgeries was 3.5 years (IQR, 1.9–5.2 years), the estimated median recurrence-free survival was 1.8 years. For the patients with multiple metastatic sites, molecularly targeted therapies were given to six (30%) patients. When the median follow-up period was 4.1 years (IQR, 3.0–4.4 years), no disease progression was observed.

Conclusions

The pancreas is frequently the only metastatic site and metastasis typically occurs a long time after nephrectomy. The OS period of these patients is long and both surgical and medical treatment resulted in good outcomes.
Literature
1.
go back to reference Zerbi A, Ortolano E, Balzano G, Borri A, Beneduce AA, Di Carlo V. Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection? Ann Surg Oncol. 2008;15:1161–8.CrossRefPubMed Zerbi A, Ortolano E, Balzano G, Borri A, Beneduce AA, Di Carlo V. Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection? Ann Surg Oncol. 2008;15:1161–8.CrossRefPubMed
2.
go back to reference Konstantinidis IT, Dursun A, Zheng H, Wargo JA, Thayer SP, Fernandez-del Castillo C, et al. Metastatic tumors in the pancreas in the modern era. J Am Coll Surg. 2010;211:749–53.CrossRefPubMedPubMedCentral Konstantinidis IT, Dursun A, Zheng H, Wargo JA, Thayer SP, Fernandez-del Castillo C, et al. Metastatic tumors in the pancreas in the modern era. J Am Coll Surg. 2010;211:749–53.CrossRefPubMedPubMedCentral
3.
go back to reference Ballarin R, Spaggiari M, Cautero N, De Ruvo N, Montalti R, Longo C, et al. Pancreatic metastases from renal cell carcinoma: the state of the art. World J Gastroenterol. 2011;17:4747–56.CrossRefPubMedPubMedCentral Ballarin R, Spaggiari M, Cautero N, De Ruvo N, Montalti R, Longo C, et al. Pancreatic metastases from renal cell carcinoma: the state of the art. World J Gastroenterol. 2011;17:4747–56.CrossRefPubMedPubMedCentral
4.
go back to reference Wente MN, Kleeff J, Esposito I, Hartel M, Müller MW, Fröhlich BE, et al. Renal cancer cell metastasis into the pancreas: a single-center experience and overview of the literature. Pancreas. 2005;30:218–22.CrossRefPubMed Wente MN, Kleeff J, Esposito I, Hartel M, Müller MW, Fröhlich BE, et al. Renal cancer cell metastasis into the pancreas: a single-center experience and overview of the literature. Pancreas. 2005;30:218–22.CrossRefPubMed
5.
go back to reference Bennington JL. Proceedings: Cancer of the kidney–etiology, epidemiology, and pathology. Cancer. 1973;32:1017–29.CrossRefPubMed Bennington JL. Proceedings: Cancer of the kidney–etiology, epidemiology, and pathology. Cancer. 1973;32:1017–29.CrossRefPubMed
6.
go back to reference Masetti M, Zanini N, Martuzzi F, Fabbri C, Mastrangelo L, Landolfo G, et al. Analysis of prognostic factors in metastatic tumors of the pancreas: a single-center experience and review of the literature. Pancreas. 2010;39:135–43.CrossRefPubMed Masetti M, Zanini N, Martuzzi F, Fabbri C, Mastrangelo L, Landolfo G, et al. Analysis of prognostic factors in metastatic tumors of the pancreas: a single-center experience and review of the literature. Pancreas. 2010;39:135–43.CrossRefPubMed
7.
go back to reference Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear-cell renal carcinoma to the pancreas: an indication for pancreatic surgery. Ann Surg Oncol. 2006;13:75–85.CrossRefPubMed Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear-cell renal carcinoma to the pancreas: an indication for pancreatic surgery. Ann Surg Oncol. 2006;13:75–85.CrossRefPubMed
8.
go back to reference Akashi Y, Saiura A, Kishi Y, Koga R, Morimura R, Yoshioka R, et al. Outcome after surgical resection of isolated metastases to the pancreas. Hepatogastroenterology. 2010;57:1549–52.PubMed Akashi Y, Saiura A, Kishi Y, Koga R, Morimura R, Yoshioka R, et al. Outcome after surgical resection of isolated metastases to the pancreas. Hepatogastroenterology. 2010;57:1549–52.PubMed
9.
go back to reference Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356:115–24.CrossRefPubMed Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007;356:115–24.CrossRefPubMed
10.
go back to reference Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007;356:125–34.CrossRefPubMed Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M, et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007;356:125–34.CrossRefPubMed
11.
go back to reference Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009;27:5794–9.CrossRefPubMed Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, et al. Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol. 2009;27:5794–9.CrossRefPubMed
12.
go back to reference Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. 2004 WHO Classification of the Renal Tumors of the Adults. Eur Urol. 2006;49:798–805.CrossRefPubMed Lopez-Beltran A, Scarpelli M, Montironi R, Kirkali Z. 2004 WHO Classification of the Renal Tumors of the Adults. Eur Urol. 2006;49:798–805.CrossRefPubMed
13.
go back to reference Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–93.CrossRefPubMed Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–93.CrossRefPubMed
14.
go back to reference Motzer RJ, Murphy BA, Bacik J, Russa P, Mazudmar M. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2001;20:289–96.CrossRef Motzer RJ, Murphy BA, Bacik J, Russa P, Mazudmar M. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2001;20:289–96.CrossRef
15.
go back to reference Choueiri TK, Garcia JA, Elson P, Khasawneh M, Usman S, Golshayan AR, et al. Clinical factors associated with outcome in patients with metastatic clear-cell renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. Cancer. 2007;110:543–50.CrossRefPubMed Choueiri TK, Garcia JA, Elson P, Khasawneh M, Usman S, Golshayan AR, et al. Clinical factors associated with outcome in patients with metastatic clear-cell renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. Cancer. 2007;110:543–50.CrossRefPubMed
16.
go back to reference Patil S, Figlin RA, Hutson TE, Michaelson MD, Négrier S, Kim ST, et al. Prognostic factors for progression-free and overall survival with sunitinib targeted therapy and with cytokine as first-line therapy in patients with metastatic renal cell carcinoma. Ann Oncol. 2011;22:295–300.CrossRefPubMed Patil S, Figlin RA, Hutson TE, Michaelson MD, Négrier S, Kim ST, et al. Prognostic factors for progression-free and overall survival with sunitinib targeted therapy and with cytokine as first-line therapy in patients with metastatic renal cell carcinoma. Ann Oncol. 2011;22:295–300.CrossRefPubMed
17.
go back to reference Yuasa T, Takahashi S, Hatake K, Yonese J, Fukui I. Biomarkers to Predict Response to Sunitinib Therapy and Prognosis in Metastatic Renal Cell Cancer. Cancer Sci. 2012;102:1949–57.CrossRef Yuasa T, Takahashi S, Hatake K, Yonese J, Fukui I. Biomarkers to Predict Response to Sunitinib Therapy and Prognosis in Metastatic Renal Cell Cancer. Cancer Sci. 2012;102:1949–57.CrossRef
18.
go back to reference Yuasa T, Urakami S, Yamamoto S, Yonese J, Takahashi S, Hatake K, et al. Treatment outcome and prognostic factors of the patients with renal cell cancer bone metastasis. Clin Exp Metastasis. 2011;28:405–11.CrossRefPubMed Yuasa T, Urakami S, Yamamoto S, Yonese J, Takahashi S, Hatake K, et al. Treatment outcome and prognostic factors of the patients with renal cell cancer bone metastasis. Clin Exp Metastasis. 2011;28:405–11.CrossRefPubMed
19.
go back to reference Yuasa T, Tsuchiya N, Horikawa Y, Narita S, Inoue T, Urakami S, et al. Clinical Efficacy and prognostic factors for overall survival in Japanese patients with metastatic renal cell cancer treated with sunitinib. BJU Int. 2012;109:1349–54.CrossRefPubMed Yuasa T, Tsuchiya N, Horikawa Y, Narita S, Inoue T, Urakami S, et al. Clinical Efficacy and prognostic factors for overall survival in Japanese patients with metastatic renal cell cancer treated with sunitinib. BJU Int. 2012;109:1349–54.CrossRefPubMed
20.
go back to reference Kroeger N, Choueiri TK, Lee JL, Bjarnason GA, Knox JJ, Mackenzie MJ, et al. Survival Outcome and Treatment Response of Patients with Late Relapse from Renal Cell Carcinoma in the Era of Targeted Therapy. Eur Urol. S0302-2838(13)00746-X. doi:10.1016/j.eururo.2013.07.031. [Epub ahead of print] Kroeger N, Choueiri TK, Lee JL, Bjarnason GA, Knox JJ, Mackenzie MJ, et al. Survival Outcome and Treatment Response of Patients with Late Relapse from Renal Cell Carcinoma in the Era of Targeted Therapy. Eur Urol. S0302-2838(13)00746-X. doi:10.1016/j.eururo.2013.07.031. [Epub ahead of print]
21.
go back to reference Sternberg CN, Davis ID, Mardiak J, Szczylik C, Lee E, Wagstaff J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol. 2010;28:1061–8.CrossRefPubMed Sternberg CN, Davis ID, Mardiak J, Szczylik C, Lee E, Wagstaff J, et al. Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol. 2010;28:1061–8.CrossRefPubMed
22.
go back to reference Okano K, Yamamoto J, Kosuge T, Yamamoto S, Sakamoto M, Nakanishi Y, et al. Fibrous pseudocapsule of metastatic liver tumors from colorectal carcinoma. Clinicopathologic study of 152 first resection cases. Cancer. 2000;89:267–75.CrossRefPubMed Okano K, Yamamoto J, Kosuge T, Yamamoto S, Sakamoto M, Nakanishi Y, et al. Fibrous pseudocapsule of metastatic liver tumors from colorectal carcinoma. Clinicopathologic study of 152 first resection cases. Cancer. 2000;89:267–75.CrossRefPubMed
23.
go back to reference Iguchi T, Aishima S, Sanefuji K, Fujita N, Sugimachi K, Gion T, et al. Both fibrous capsule formation and extracapsular penetration are powerful predictors of poor survival in human hepatocellular carcinoma: a histological assessment of 365 patients in Japan. Ann Surg Oncol. 2009;16:2539–46.CrossRefPubMed Iguchi T, Aishima S, Sanefuji K, Fujita N, Sugimachi K, Gion T, et al. Both fibrous capsule formation and extracapsular penetration are powerful predictors of poor survival in human hepatocellular carcinoma: a histological assessment of 365 patients in Japan. Ann Surg Oncol. 2009;16:2539–46.CrossRefPubMed
24.
go back to reference Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg. 2002;235:86–91.CrossRefPubMedPubMedCentral Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg. 2002;235:86–91.CrossRefPubMedPubMedCentral
25.
go back to reference Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, Nespoli A, et al. Surgical treatment of liver metastases of gastric cancer: is local treatment in a systemic disease worthwhile? HPB (Oxford). 2012;14:209–15.CrossRef Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, Nespoli A, et al. Surgical treatment of liver metastases of gastric cancer: is local treatment in a systemic disease worthwhile? HPB (Oxford). 2012;14:209–15.CrossRef
Metadata
Title
Clinical outcome of patients with pancreatic metastases from renal cell cancer
Authors
Takeshi Yuasa
Naoko Inoshita
Akio Saiura
Shinya Yamamoto
Shinji Urakami
Hitoshi Masuda
Yasuhisa Fujii
Iwao Fukui
Yuichi Ishikawa
Junji Yonese
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-1050-2

Other articles of this Issue 1/2015

BMC Cancer 1/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine