Background: Clear cell renal cell carcinoma (RCC) is the most common primary tumor that metastasizes to the pancreas, and surgery is the established treatment option. The aim of this study was to compare surgical treatment options for RCC metastases to the pancreas and to assess long-term outcomes, identifying risk factors for recurrence and death.Methods: We retrospectively analyzed data from 62 patients with RCC metastases to the pancreas who underwent pancreatic surgery at the Department of Gastrointestinal Surgery, Medical University of Silesia, Katowice. Patients were divided into two groups: those who underwent local tumor removal (group A, N = 10) and those who underwent classical pancreatic resection (group B, N = 52). Demographic data, postoperative course, histological findings, and clinical outcomes—recurrence-free survival (PFS) and overall survival (OS)—were analyzed.Results: In group A, tumors were smaller (p< 0.001) and exclusively single (p= 0.100), and Clavien–Dindo complications were milder, with a predominance of grade 0 (90% vs. 28.8%;p= 0.042). In group B, blood loss was greater (p< 0.001), and hospitalization was longer (median 12.5 days vs. 10.5 days;p= 0.022) compared with group A. Group A had a longer PFS (144 months vs. 61 months;p= 0.007) and longer OS (144 months vs. 70 months;p= 0.006) compared with group B. In the entire cohort, independent factors associated with worse OS in multivariate analysis were larger tumor size (p= 0.003), lymphatic invasion (p< 0.001), vascular invasion (p< 0.001), perineural invasion (p< 0.001), R1 resection (p< 0.001), and symptoms of the metastases (p< 0.001).Conclusions: The prognosis following surgical resection of pancreatic RCC metastases is excellent: median OS is 77 months, and 5-year survival reaches 71.4%. In multivariate analysis, the type of surgical treatment is not significantly associated with OS or PFS. The choice of surgical procedure should depend on the preoperative CT results and the intraoperative assessment of the surrounding tissues.
背景：透明细胞肾细胞癌（RCC）是最常转移至胰腺的原发性肿瘤，手术是公认的治疗选择。本研究旨在比较胰腺RCC转移瘤的手术治疗方案，评估长期预后，并识别复发和死亡的风险因素。 方法：我们回顾性分析了62例在卡托维兹西里西亚医科大学胃肠外科接受胰腺手术的胰腺RCC转移患者数据。患者分为两组：接受局部肿瘤切除组（A组，N=10）和接受经典胰腺切除术组（B组，N=52）。分析内容包括人口统计学数据、术后病程、组织学发现以及临床结局——无进展生存期（PFS）和总生存期（OS）。 结果：A组肿瘤更小（p<0.001）且均为单发（p=0.100），Clavien-Dindo并发症分级更轻，以0级为主（90% vs. 28.8%；p=0.042）。与A组相比，B组术中失血量更大（p<0.001），住院时间更长（中位数12.5天 vs. 10.5天；p=0.022）。A组较B组具有更长的PFS（144个月 vs. 61个月；p=0.007）和更长的OS（144个月 vs. 70个月；p=0.006）。在整个队列的多变量分析中，与较差OS相关的独立因素包括：较大肿瘤体积（p=0.003）、淋巴侵犯（p<0.001）、血管侵犯（p<0.001）、神经侵犯（p<0.001）、R1切除（p<0.001）以及转移灶相关症状（p<0.001）。 结论：胰腺RCC转移瘤手术切除后预后良好：中位OS为77个月，5年生存率达71.4%。多变量分析显示，手术治疗类型与OS或PFS无显著相关性。手术方式的选择应基于术前CT结果和术中周围组织评估。
肿瘤(癌症)患者之家