832P - Pancreatic metastases from renal cell carcinoma: Incidence and prognostic impact

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Renal Cell Cancer
Presenter palma Giglione
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors P. Giglione1, F. Lombardo2, C. Paglino2, A. Ferrari2, F. Reversi2, C. Porta2
  • 1Medical Oncolgy, I.R.C.C.S San Matteo University Hospital Foundation, 27100 - Pavia/IT
  • 2Medical Oncolgy, I.R.C.CI.R.C.C.S. San Matteo University Hospital Foundation, 27100 - Pavia/IT

Abstract

Aim

About 25% of RCC patients present with metastatic disease at the time of diagnosis, while 30% of patients with localized primary will develop distant metastases after nephrectomy. The most common sites of metastases from RCC are lungs, bones and liver; pancreatic metastases are rare and often associated with thyroid metastases.

Methods

We reviewed our data-base of 795 RCC patients evaluated at our Center between 2004 and 2013 (data cut-off: 31-12-2013), isolating 57 (7.2%) patients with pancreatic metastases.

Results

Of these 57 patients, 6 only had pancreatic metastases which were synchronous to the primary, while 51 patients developed metachronous pancreatic metastases, with a median time from first RCC diagnosis to the development of pancreatic metastases of 74 months (mean: 87, range: 1-304). A classical clear cell histology was documented in all cases. An histological confirmation of the metastatic nature of the pancreatic lesions was obtained In 17 cases only (30%). The 96.5% of patients had multiple sites of metastases, while just 2 (3.5%) had pancreatic metastases only; 6 patients presented concomitant thyroid metastases. As far as treatment, 8 cases (14%) were treated with surgical resection, whose type and extent was adapted to the location of the tumor. One-, 5-, and 10-year mortality rates in our patients with pancreatic metastases were 3.5%, 35% and 61.4, respectively, while median overall survival (calculated from the time of the development of the first pancreatic metastases to death) was 24 months (mean: 36.6 ± 34.3 SD, range: 0-135). One-, 5-, and 10-year mortality rates in patients treated with surgical resection were 0%, 12,5% and 62.5% respectively, while median overall survival (calculated from the time of the development of the first pancreatic metastases to death) was 48 months (mean: 50.1 ± 32.1 SD, range: 15-80).

Conclusions

Pancreatic metastases from RCC account for about 7.2% of all metastatic sites in our case series, are usually metachronous and a relatively better prognosis. Furthermore, the association of pancreatic and thyroid metastases appears to be rare. Finally, the surgical resection of pancreatic metastases may have a beneficial impact on patients' outcome and should thus be always considered, even though in selected patients (and referral centers for pancreatic surgery).

Disclosure

All authors have declared no conflicts of interest.