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Surgical Resection Does Not Improve Survival in Patients with Renal Metastases to the Pancreas in the Era of Tyrosine Kinase Inhibitors
- Publication Year :
- 2014
-
Abstract
- The aim of this study was to compare survival of resected and unresected patients in a large cohort of patients with metastases to the pancreas from renal cell carcinoma (PM-RCC). Data from 16 Italian centers involved in the treatment of metastatic RCC were retrospectively collected. The Kaplan–Meier and log-rank test methods were used to evaluate overall survival (OS). Clinical variables considered were sex, age, concomitant metastasis to other sites, surgical resection of PM-RCC, and time to PM-RCC occurrence. Overall, 103 consecutive patients with radically resected primary tumors were enrolled in the analysis. PM-RCCs were synchronous in only three patients (3 %). In 56 patients (54 %), the pancreas was the only metastatic site, whereas in the other 47 patients, lung (57 %), lymph nodes (28 %), and liver (21 %) were the most common concomitant metastatic sites. Median time for PM-RCC occurrence was 9.6 years (range 0–24 years) after nephrectomy. Surgical resection of PM-RCC was performed in 44 patients (median OS 103 months), while 59 patients were treated with tyrosine kinase inhibitors (TKIs; median OS 86 months) (p = 0.201). At multivariate analysis, Memorial Sloan Kettering Cancer Center risk group was the only independent prognostic factor. None of the other clinical variables, such as age, sex, pancreatic surgery, or the presence of concomitant metastases, were significantly associated with outcome in PM-RCC patients. The presence of PM-RCC is associated with a long survival, and surgical resection does not improve survival in comparison with TKI therapy. However, surgical resection leads to a percentage of disease-free PM-RCC patients.
- Subjects :
- Oncology
Male
medicine.medical_treatment
urologic and male genital diseases
Gastroenterology
Nephrectomy
Metastasis
Surgical oncology
Renal cell carcinoma
Antineoplastic Combined Chemotherapy Protocols
80 and over
Medicine
Aged, 80 and over
Middle Aged
Protein-Tyrosine Kinases
Prognosis
Combined Modality Therapy
female genital diseases and pregnancy complications
Kidney Neoplasms
Survival Rate
Local
Lymphatic Metastasis
Female
Adult
medicine.medical_specialty
Internal medicine
Carcinoma
Humans
Neoplasm Invasiveness
Survival rate
Carcinoma, Renal Cell
Protein Kinase Inhibitors
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Renal Cell
Cancer
medicine.disease
not applicable
Pancreatic Neoplasms
Neoplasm Recurrence
Concomitant
Surgery
Neoplasm Recurrence, Local
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....a4beca5a146d193c97011dff43977ec5